中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (02): 123-125.doi: 10.3969/j.issn.1671-4091.2018.02.00

• 护理研究 • 上一篇    下一篇

赋能教育模式对血液透析患者钙磷代谢及营养状态的影响

陈金霄1, 施素华1, 邹丽敏1, 沈曲2   

  1. 1.厦门大学附属成功医院(解放军第174医院)肾内科  2.厦门大学医学院护理系
  • 收稿日期:2017-08-24 修回日期:2017-12-03 出版日期:2018-02-12 发布日期:2018-02-12
  • 通讯作者: 施素华 Sunflyingdance@163.com 沈曲 qushen@xmu.edu.cn E-mail:369716292@qq.com
  • 基金资助:

    国家自然科学基金项目(No: 71403232);厦门市科技计划项目(No:3502Z20174037)

The influence of empowerment education model on calcium-phosphate metabolism and nutritional status in maintenance hemodialysis patients

  • Received:2017-08-24 Revised:2017-12-03 Online:2018-02-12 Published:2018-02-12

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摘要： 目的观察赋能教育模式对血液透析伴矿物质及骨代谢异常患者钙磷代谢及营养状态的影响。方法组建赋能教育模式团队，选择2015 年6 月至2016 年6 月我院透析中心维持性血液透析(maintenance hemodialysis，MHD)患者60 例，赋能教育模式干预12 周后，采用自身前后对照的方法，比较患者血钙、血磷、钙磷乘积、全段甲状旁腺激素(intact parathyroid hormone,iPTH)、血红蛋白(hemoglobulin，Hb)、血浆白蛋白(albumin，Alb)、前白蛋白(pre albumin PAB)、肱三头肌皮褶厚度(triceps skinfold thickness,TSF)和上臂中段肌肉周径(mid-arm muscle circumference,MAMC)。结果赋能教育模式后患者血钙、血磷、钙磷乘积、赋能教育模式后患者血钙(t=0.017，P=0.002)、血磷(t=0.368，P=0.005)、钙磷乘积(t=3.089，P≤0.001)、iPTH 降低(t=4.216，P=0.004), Hb(t=-1.267，P=0.039)、Alb 升
高(t=-1.051，P=0.045)，TSF 升高(t=-2.546，P=0.009)，MAMC 有升高趋势，但差异尚无统计学意义(t=-1.056，P=0.736)。结论赋能教育模式可改善血液透析伴矿物质及骨代谢异常患者钙磷代谢及营养状态。

关键词: 赋能教育模式, 血液透析, 甲状旁腺素, 血浆白蛋白

Abstract: Objective To observe the influence of empowerment education model on calcium- phosphate metabolism and nutritional status in maintenance hemodialysis (MHD) patients with abnormal mineral and bone metabolism. Methods We established a team for empowerment education model. A total of 60 MHD patients treated in our blood purification center from June 2015 to June 2016 were enrolled in this study. After the intervention with empowerment education model for 12 weeks, the values of serum calcium and phosphorus, calcium-phosphorus product, iPTH, hemoglobin, plasma albumin, prealbumin, triceps skinfold thickness, and mid-arm muscle circumference were compared before and after the intervention. Results After the intervention of empowerment education model, the levels of serum calcium and serum phosphorus, calcium-phosphorus product, iPTH decreased (t=0.017, P=0.002), the levels of Hb (t=-1.267, P=0.039), albumin (t=-1.051, P=0.045) and triceps skinfold thickness (t=-2.546, P= 0.009) increased, but the change of midarm muscle circumference was statistically insignificant (t=-1.056, P=0.736). Conclusion Empowerment education model can improve calcium-phosphate metabolism and nutritional status in MHD patients with abnormal mineral and bone metabolism.

Key words: Empowerment education model, Hemodialysis, Parathyroid hormone, Serum albumin