目的 探讨基于个体化食物成分表的饮食指导对腹膜透析患者血磷水平的影响.方法 采用便利抽样法,选取2016年3 —5月在河北医科大学第二医院肾内科腹膜透析中心规律腹膜透析大于3个月,血磷值>1.78 mmol/L的患者共83例,利用个体化的食物成分表进行饮食干预6个月,期间磷结合剂的使用剂量不变.采用自身前后对照的方法,比较干预前后患者血磷达标情况、生化指标及其他腹膜透析相关指标的变化情况.结果 饮食干预6个月后,患者的血磷达标率为71%,血磷、血钾、甲状旁腺激素较干预前均下降,血红蛋白、血白蛋白较干预前升高,差异均有统计学意义(P<0.05).干预后患者腹膜透析相关指标中,血压控制较干预前改善,差异有统计学意义(P<0.05),其余指标干预前后比较差异无统计学意义(P>0.05).结论 基于个体化食物成分表的饮食指导可有效降低腹膜透析患者血磷水平,改善患者营养状态,并可简化腹膜透析中心饮食教育工作流程.%Objective To evaluate the effect of individualized food composition table on serum phosphorus management for patients undergoing peritoneal dialysis(PD). Methods A total of 83 patients who were treated with PD for over 3 months with serum phosphorus greater than 1.78 mmol/L were included from March to May 2016 in PD Center of the Second Hospital of Hebei Medical University by convenient sampling. They received dietary guidance with individualized food composition table and stable phosphorus binding agent. After 6 months, level of serum phosphorus, biochemical indicators and other PD indicators before and after the intervention were compared. Results After 6 months of diet intervention, the patients' serum phosphorus achieved rate was 71%. Serum phosphorus, potassium, parathyroid hormone decreased, and hemoglobin, serum albumin increased (P<0.05). For the PD indicators, blood pressure control was improved (P<0.05), and the rest of the indicators had no difference compared with those before intervention (P>0.05). Conclusions Dietary intervention based on individual food composition table can effectively reduce the serum phosphorus levels in patients with PD,and improve the nutritional status and simplify education working process of the PD center diet as well.
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