中国血液净化

中国血液净化 ›› 2022, Vol. 21 ›› Issue (07): 536-540.doi: 10.3969/j.issn.1671-4091.2022.07.016

• 护理研究 • 上一篇    下一篇

基于老年营养风险指数的分层式饮食干预对老年持续性血液透析患者营养状况及自我效能的影响 

王 颖   吴娟娟    许方方    沈 霞    叶 红    

  1. 210000 南京，1南京医科大学第二附属医院肾内科

  • 收稿日期:2021-10-29 修回日期:2022-02-19 出版日期:2022-07-12 发布日期:2022-07-12
  • 通讯作者: 叶红 E-mail:yehong@njmu.edu.cn

Effect of geriatric nutritional risk index (GNRI)-based stratified diet intervention on nutritional status  and self- efficacy in elderly patients with maintenance hemodialysis 

  1. Department of Nephrology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
  • Received:2021-10-29 Revised:2022-02-19 Online:2022-07-12 Published:2022-07-12

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摘要： 目的 探究基于老年营养风险指数(geriatric nutritional risk index,GNRI)分层式饮食
干预对老年维持性血液透析(maintenance hemodialysis,MHD)患者营养状况及自我效能的影响。 方
法 随机选取2020年1月～2021年1月南京医科大学第二附属医院60例老年MHD患者，采用随机数字表
法分干预组和对照组，每组30例。对照组实施常规干预措施，干预组在常规干预措施基础上实施GNRI分
层式饮食干预。比较2组干预前及干预3个月后营养状况[主观整体评估量表(scored patient-generated subjective global assessment,PG-SGA)评分、体质量指数(body mass index,BMI)及肱三头肌皮
褶厚度(triceps skin fold,TSF)]、自我效能[自我效能量表(general self-efficacy scale,GSES)评
分]、饮食治疗态度[血液透析病人饮食治疗态度量表(the attitude scale for the dietary therapy
of hemodialysis patients, ASDTH)评分]、生活质量[肾脏疾病生活质量简表(kidney disease quality of life short form,KDQ)评分]变化。 结果 干预3个月后，干预组PG-SGA评分、BMI、TSF、事件应
对、目标达成和个体解决问题、ASDTH 评分、KDQ 评分均高于对照组(t 值分别为 5.450、-2.199、-3.510、
- 5.122、- 5.142、- 5.085、- 4.280、- 4.959，P 值 分 别 为 ＜0.001、0.032、0.001、＜0.001、＜0.001、

0.001、＜0.001、＜0.001)。 结论 GNRI分层式饮食干预可改善老年MHD患者营养状况，有助于增强其
自我效能，改善饮食治疗态度，提高生活质量，具有较高临床应用价值。

关键词:

老年营养风险指数, 分层式饮食干预, 持续性血液透析, 营养状况, 自我效能

Abstract: Objective To explore the effect of stratified dietary intervention based on geriatric nutritional risk index (GNRI) on nutritional status and self-efficacy in elderly patients with continuous hemodialysis
(MHD). Methods A total of 60 elderly MHD patients treated in The Second Affiliated Hospital of Nanjing
Medical University from January 2020 to January 2021 were randomly selected and divided into an intervention group (n=30) and a control group (n=30) by random number table method. The control group implemented conventional intervention measures, and the intervention group implemented GNRI stratified dietary intervention in addition to the conventional intervention measures. The changes of nutritional status after 3 months
of the interventions, including the score of subjective global assessment (scored patient-generated subjective
global assessment, PG-SGA score), body mass index (body mass index, BMI), triceps skin triceps skin fold
(TSF), self- efficacy (general self- efficacy scale score, GSES score), dietary treatment attitude (the attitude
scale for the dietary therapy of hemodialysis patients, ASDTH score), and quality of life (kidney disease quality of life short form score, KDQ score) were compared between the two groups. Results After 3 months of
the interventions, PG-SGA score, BMI, TSF, event coping, goal achievement and individual problem solving,
ASDTH score and KDQ score were higher in the intervention group than in the control group (t=5.450,
- 2.199, - 3.510, - 5.122, - 5.142, - 5.085, - 4.280 and - 4.959, respectively; P<0.001, =0.032, =0.001, <0.001,
<0.001, =0.001, <0.001 and <0.001, respectively). Conclusion GNRI stratified dietary intervention can improve the nutritional status, self- efficacy, diet therapy attitude and quality of life in elderly MHD patients,
highlighting its value in clinical application.

Key words: Geriatric nutritional risk index, Stratified diet intervention, Maintenance hemodialysis, Nutritional status, Self-efficacy

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