摘要
目的探讨营养控制情况对老年终末期肾病维持性血液透析患者动静脉内瘘晚期失功的影响。方法于2021年6月—2023年10月,选择南京大学医学院附属金陵医院诊治的72例老年终末期肾病患者进行观察,其中根据营养控制方式的不同分为观察组和对照组,每组36例。对照组进行常规的营养控制,观察组在对照组处理的基础上引入个性化营养控制。结合多项临床指标和营养评估,分析营养控制与患者动静脉内瘘晚期失功的相关性。结果2组ALB、BMI在营养控制下差异均有统计学意义(P<0.05);2组PA在营养控制前后比较差异无统计学意义(P>0.05)。观察组Kt/V、URR指标值均高于对照组,差异有统计学意义(P<0.05)。高血压及糖尿病控制良好的患者,其动静脉内瘘晚期失功的发生率相对较低(P<0.05)。观察组经过营养控制后可能减少营养状况异常的出现,降低营养不良率。营养状况不佳的患者失功风险更高。结论对于老年终末期肾病维持性血液透析患者,应重视营养控制、基础疾病控制、透析充分性等相关因素的管理,以降低老年患者动静脉内瘘晚期失功的风险。
Objective To explore the effects of nutritional control on late-stage dysfunction of arteriovenous fistulas in elderly patients with end-stage renal disease undergoing maintenance hemodialysis.Methods From June 2021 to October 2023,72 elderly patients with end-stage renal disease diagnosed and treated in Jinling Hospital Affiliated to Medical College of Nanjing University were selected for observation.According to different nutritional control methods,they were divided into control group and observation group,with 36 cases in each group.The control group received routine nutrition control,and the observation group received personalized nutrition control based on the control group.Combined with a number of clinical indicators and nutritional evaluation,the correlation between nutrition control and late-stage dysfunction of arteriovenous fistulas was analyzed.Results There were statistically significant differences in ALB and BMI between the two groups under nutritional control(P<0.05).There was no significant difference in PA between the two groups before and after nutritional control(P>0.05).The values of Kt/V and URR indexes of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of late-stage dysfunction of arteriovenous fistulas was relatively low in patients with well-controlled hypertension and diabetes(P<0.05).The nutritional control could reduce the occurrence of abnormal nutritional status in the observation group and lower the incidence of malnutrition.Patients with poor nutritional status had a higher risk of late-stage dysfunction of arteriovenous fistulas.Conclusion For elderly patients with end-stage renal disease undergoing maintenance hemodialysis,attention should be paid to the management of related factors such as nutritional control,underlying disease control,and dialysis adequacy to reduce the risk of late-stage dysfunction of arteriovenous fistulas.
作者
张欢
贾美荣
曹丽霞
Zhang Huan;Jia Meirong;Cao Lixia(Blood Purification Center,Department of Nephrology,Jinling Hospital Affiliated to Medical College of Nanjing University,Nanjing,Jiangsu,210002,P.R.China)
出处
《老年医学与保健》
CAS
2024年第4期1106-1110,共5页
Geriatrics & Health Care
关键词
老年
终末期肾病
营养控制
血液透析
动静脉内瘘晚期失功
elderly
end-stage renal disease
nutritional control
hemodialysis
late-stage dysfunction of arteriovenous fistulas
