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蛋白质和能量摄入:两种食物服务在血液透析治疗患者中的比较。

Protein and energy intake: Comparison of two food services in patients during hemodialysis treatment.

机构信息

Radboud University Medical Center, Department of Gastroenterology and Hepatology, Dietetics and Intestinal Failure, Nijmegen, The Netherlands.

Radboud University Medical Center, Department of Nephrology, Nijmegen, The Netherlands.

出版信息

Nutrition. 2021 Oct;90:111260. doi: 10.1016/j.nut.2021.111260. Epub 2021 Apr 6.

Abstract

OBJECTIVES

Radboud University Medical Center introduced a new food service (NFS) to the hemodialysis (HD) department, which contains several small protein-rich foods and adheres to the Dutch dietary HD guidelines. The objectives were to investigate whether the NFS improves protein and energy intake compared with the old food service (OFS), the number of symptomatic hypotensive events (SHEs), and patient satisfaction.

METHODS

This was a prospective cohort (pilot) study of 25 adult patients with HD at the Radboud University Medical Center between August 2018 and February 2019. Differences in protein and energy intake over time by repeated measurements of the OFS and NFS were evaluated by linear mixed models with adjustments for confounders. SHEs, defined as a systolic drop >20 mmHg between two blood pressure measurements and 1) temporary or permanent stop ultrafiltration, 2) nausea, or 3) dizziness were collected. Patient satisfaction was determined by means of a self-developed questionnaire.

RESULTS

Protein and energy intake for the OFS and NFS differed significantly. Mean ± standard deviation for protein intake was 26 ± 11 g and 31 ± 13 g, respectively, and for energy intake 603 ± 218 kcal and 724 ± 244 kcal, respectively. No increase in SHEs occurred between the food services (2 SHEs at OFS vs 1 SHE at NFS). OFS patient satisfaction was graded 6.7 ± 2.3 and NFS was graded 7.3 ± 1.7.

CONCLUSIONS

NFS resulted in increased protein and energy intake and patient satisfaction, but no increase in SHEs was observed.

摘要

目的

拉德堡德大学医学中心(Radboud University Medical Center)为血液透析(HD)部门引入了一种新的餐饮服务(NFS),其中包含几种富含蛋白质的小食品,并符合荷兰 HD 饮食指南。本研究旨在调查与旧餐饮服务(OFS)相比,NFS 是否能提高蛋白质和能量摄入、减少症状性低血压事件(SHE)的发生次数并提高患者满意度。

方法

这是一项前瞻性队列(试点)研究,纳入 2018 年 8 月至 2019 年 2 月在拉德堡德大学医学中心接受 HD 治疗的 25 名成年患者。通过重复测量 OFS 和 NFS,采用线性混合模型评估时间点上的蛋白质和能量摄入的差异,并对混杂因素进行调整。SHE 的定义为两次血压测量之间收缩压下降>20mmHg,且同时出现以下 1 种或多种情况:1)临时或永久性停止超滤;2)恶心;3)头晕。通过自行设计的问卷评估患者满意度。

结果

OFS 和 NFS 的蛋白质和能量摄入存在显著差异。OFS 的平均(±标准差)蛋白质摄入量为 26±11g,能量摄入量为 603±218kcal;NFS 的平均(±标准差)蛋白质摄入量为 31±13g,能量摄入量为 724±244kcal。两种餐饮服务之间未发生 SHE 增加(OFS 发生 2 次 SHE,NFS 发生 1 次 SHE)。OFS 的患者满意度评分为 6.7±2.3,NFS 的评分为 7.3±1.7。

结论

NFS 可增加蛋白质和能量摄入并提高患者满意度,但未观察到 SHE 增加。

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