Objective To explore the effects of a doctor-led intensive diet education on serum phosphorus in maintenance hemodialysis (MHD) patients. Methods Sixty MHD patients with hyperphosphatemia in the First Peo-ple's Hospital of Nanning were divided into observation group (n=30) and control group (n=30) from September 2015 to March 2016. The control group received routine diet education, while the observation group received doctor-led inten-sive diet education as a therapeutic alliance. The effects were evaluated ofter 3 months. Results Before intervention, there were no significant difference in age, hemodialysis duration, calcium, phosphorus, calcium × phosphorus products, hemoglobin, blood urea nitrogen, albumin, C-reactive protein, parathyroid hormone between the two groups. After 3 months, the level of serum phosphorus and calcium×phosphorus in the observation group were (1.89±0.40) mmol/L and (48.03±11.61) mg2/dL2, as compared with (2.29±0.61) mmol/L and (56.61±17.59) mg2/dL2 in the control group (P<0.05), while no significant difference was found in the level of calcium, hemoglobin, blood urea nitrogen, albumin, C-reactive protein, parathyroid hormone (P>0.05). Conclusion The doctor-led intensive diet education plays a positive role in the control of serum phosphorus in MHD patients.%目的 探讨由医生主导的干预模式对高磷血症维持性血液透析(MHD)患者血磷的影响.方法 将2015年9月至2016年3月南宁市第一人民医院透析中心高磷血症(血磷>1.78 mmol/L)患者60例,采用随机数表法分为观察组和对照组,每组30例.对照组接受"常规"透析饮食教育,观察组在"常规"透析饮食教育基础上以"治疗联盟"的方式接受由透析医生主导的强化饮食教育.3个月后评价干预效果.结果 干预前两组患者年龄、透析时间、校正钙、血磷、钙磷乘积、血红蛋白、尿素氮、白蛋白、C反应蛋白、甲状旁腺激素等比较差异无统计学意义(P>0.05);干预3个月后,观察组和对照组患者的血磷[(1.89±0.40)mmol/L vs(2.29±0.61)mmol/L]、钙磷乘积[(48.03±11.61)mg2/dL2 vs(56.61±17.59)mg2/dL2]比较差异有统计学意义(P<0.05),而校正钙、血红蛋白、尿素氮、白蛋白、C反应蛋白、甲状旁腺激素等比较差异均无统计学意义(P>0.05).结论 医生主导的强化饮食教育模式在高磷血症MHD患者血磷控制中起到积极的作用.
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