营养控制对老年终末期肾病维持性血液透析患者动静脉内瘘晚期失功的影响

Effects of nutritional control on late-stage dysfunction of arteriovenous fistulas in elderly patients with end-stage renal disease undergoing maintenance hemodialysis

中文关键词: 老年  终末期肾病  营养控制  血液透析  动静脉内瘘晚期失功

英文关键词: elderly  end-stage renal disease  nutritional control  hemodialysis  late-stage dysfunction of arteriovenous fistulas

中文摘要:

      目的 探讨营养控制情况对老年终末期肾病维持性血液透析患者动静脉内瘘晚期失功的影响.方法 于2021年6月-2023年10月,选择南京大学医学院附属金陵医院诊治的72例老年终末期肾病患者进行观察,其中根据营养控制方式的不同分为观察组和对照组,每组36例.对照组进行常规的营养控制,观察组在对照组处理的基础上引入个性化营养控制.结合多项临床指标和营养评估,分析营养控制与患者动静脉内瘘晚期失功的相关性.结果 2组ALB、BMI在营养控制下差异均有统计学意义(P＜0.05);2组PA在营养控制前后比较差异无统计学意义(P＞0.05).观察组Kt/V、URR指标值均高于对照组,差异有统计学意义(P＜0.05).高血压及糖尿病控制良好的患者,其动静脉内瘘晚期失功的发生率相对较低(P＜0.05).观察组经过营养控制后可能减少营养状况异常的出现,降低营养不良率.营养状况不佳的患者失功风险更高.结论 对于老年终末期肾病维持性血液透析患者,应重视营养控制、基础疾病控制、透析充分性等相关因素的管理,以降低老年患者动静脉内瘘晚期失功的风险.

英文摘要:

      Objective To explore the effects of nutritional control on late-stage dysfunction of arteriovenous fistulas in elderly patients with end-stage renal disease undergoing maintenance hemodialysis.Methods From June 2021 to October 2023,72 elderly patients with end-stage renal disease diagnosed and treated in Jinling Hospital Affiliated to Medical College of Nanjing University were selected for observation.According to different nutritional control methods,they were divided into control group and observation group,with 36 cases in each group.The control group received routine nutrition control,and the observation group received personalized nutrition control based on the control group.Combined with a number of clinical indi-cators and nutritional evaluation,the correlation between nutrition control and late-stage dysfunction of arteriovenous fistulas was analyzed.Results There were statistically significant differences in ALB and BMI between the two groups under nutri-tional control(P＜0.05).There was no significant difference in PA between the two groups before and after nutritional control(P＞0.05).The values of Kt/V and URR indexes of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).The incidence of late-stage dysfunction of arteriovenous fistulas was relatively low in patients with well-controlled hypertension and diabetes(P＜0.05).The nutritional control could reduce the occurrence of abnormal nutritional status in the observation group and lower the incidence of malnutrition.Patients with poor nutritional status had a higher risk of late-stage dysfunction of arteriovenous fistulas.Conclusion For elderly patients with end-stage renal disease undergoing maintenance hemodialysis,attention should be paid to the management of related factors such as nutritional control,underlying disease control,and dialysis adequacy to reduce the risk of late-stage dysfunction of arteriove-nous fistulas.