血液透析期间香蕉摄入量对患者血清钾水平的影响:一项膳食管理的随机对照试验OACSTPCD
目的评估血液透析期间香蕉摄入量对维持性血液透析患者(maintenance hemodialysis,MHD)血清钾水平的影响。方法本研究为单中心、随机对照临床试验,于2021年9月15日至12月15日选取中国南方地区1所三级甲等医院的126例MHD患者,并将其随机分为干预组(n=64)和对照组(n=62)。干预组患者在血液透析期间摄入约250克香蕉,而对照组患者在血液透析期间不摄入任何食物。在血液透析前通过病例信息收集患者人口学信息和血液透析相关参数,通过采集患者透析前血液样品来评估实验室指标(如血常规、生化指标、炎症指标、肝功能、肾功能等)。在血液透析2 h和4 h、下次血液透析前分别测量两组患者的血清钾和血糖水平,并记录透析中相关并发症。采用重复测量方程分析对两组患者血清钾和血糖指标进行比较。结果最终122例MHD患者完成研究(干预组和对照组各61例)。结果显示,两组患者血清钾水平在组别和时间上不存在交互作用(P>0.05),而干预组患者血清钾水平在血液透析2 h(3.9±0.5比3.6±0.3)mmol/L和血液透析4 h(3.5±0.4比3.3±0.3)mmol/L均高于对照组(P<0.01)。两组患者血糖水平在组别和时间上不存在交互作用(P>0.05)。干预组患者在血液透析期间心律失常(8.2%比29.5%,P=0.003)和低钾血症的发生率(52.5%比80.3%,P=0.002)均低于对照组。结论血液透析开始时摄入约250 g香蕉不会引起高钾血症,可有效降低低钾血症和心律失常的发生率,并防止血液透析过程中血清钾水平下降过快。建议医务人员应与营养学家进一步合作,为MHD患者制订适用的膳食管理计划。
全梓林;李彩霞;赵立艳;崔冬梅;刘双信;尹燕;唐奇;曾德汉;宋利;符霞
The Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nephrology,The Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,ChinaThe Department of Nursing,The Eighth Affiliated Hospital,Sun Yat-Sen University,Shenzhen,China
预防医学
血糖水果血液透析护理钾血清
《International Journal of Nursing Sciences》 2024 (2)
P.197-204,8
supported by the Guangdong Provincial Medical Science and Technology Research Fund Project(B2023011)the Guangzhou Science and Technology Plan Project(202102080292)。
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