中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (04): 222-225.doi: 10.3969/j.issn.1671-4091.2018.04.002

• 临床研究 • 上一篇    下一篇

基于优势的个案管理模式对腹膜透析患者营养炎症状态和残余肾功能的影响

罗怡欣1,黄燕林1   

  1. 1. 广西医科大学第一附属医院肾内科
  • 收稿日期:2017-11-02 修回日期:2018-01-15 出版日期:2018-04-12 发布日期:2018-04-12
  • 基金资助:

    广西壮族自治区教育厅重点课题(编号：YB2014087)

The effect of strength model of case management on the nutritional inflammatory state and residual renal function in peritoneal dialysis patients

  • Received:2017-11-02 Revised:2018-01-15 Online:2018-04-12 Published:2018-04-12

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摘要： 【摘要】目的探讨基于优势的个案管理模式(strengths model of case management，SMCM)对腹膜透析(peritoneal dialysis,PD)患者营养炎症状态和残肾功能(residual renal function,RRF)的影响。方法采用随机数字表法选择广西医科大学第一附属医院PD 中心110 例建档在透的PD 患者，随机分为对照组和干预组各55 例。两组患者均接受常规护理，干预组在此基础上进行6 个月的优势个案管理干预，比较两组患者干预前后营养和炎症相关人体测量指标、生化指标和残余肾功能。结果干预后患者的营养不良-炎症(malnutrition-inflammation score,MIS)评分(t=6.672,P＜0.001)、上臂围(Mid- upper arm circumference, MAC) (t=- 2.949，P=0.004)、三头肌皮褶厚度(triceps skin fold,TSF) (t=- 2.002，P=0.048)、血清前白蛋白(Pre- albumin,PA) (t=- 2.072，P=0.041)和高敏C 反应蛋白(high-sensitive C-reactive protein, hs-CRP)(t=6.064，P＜0.001)显著改善，差异有统计学意义。结论基于优势的个案管理能够明显改善患者的营养不良和微炎症状态，而对于残肾功能的影响不大。

关键词: 腹膜透析, 优势, 个案管理, 营养炎症, 残余肾功能

Abstract: 【Abstract】Objective To explore the effect of strength model of case management (SMCM) on nutritional inflammatory state and residual renal function (RRF) in peritoneal dialysis (PD) patients. Methods A randomized digital table method was used to select 110 PD patients in the PD Center of The First Affiliated Hospital of Guangxi Medical University. They were randomly divided into control group (n=55) and intervention group (n=55). Routine care was used for both groups, and SMCM for 6 months on the basis of routine care was performed for intervention group. Nutritional inflammatory state related body measurements, biochemical indicators and residual renal function were compared after the intervention between the two groups. Results In intervention group after the intervention, malnutrition- inflammation (MIS) scores (t=6.672, P＜0.001), mid-upper arm circumference (MAC, t=-2.949, P=0.004), triceps skin fold (TSF, t=-2.002, P=0.048), pre-albumin (PA, t=-2.072, P=0.041) and high sensitive C-reactive protein (hs-CRP, t=6.064, P＜0.001) improved significantly. Conclusion SMCM for PD patients can significantly improve their malnutrition and inflammatory state. However, SMCM changed RRF insignificantly.

Key words: Strength Model of Case Management, Peritoneal Dialysis, inflammatory state, residual renal function