【摘要】目的本文主要探析营养评估与专病一体化饮食指导在肾病血液透析患者护理中的应用效果。方法研究时间为2017 年11 月20 日～2019 年11 月15 日，选取在浙江大学医学院附属杭州市第一人民医院肾内科进行血液透析治疗的患者131 例，以随机化原则分组，分对照组(例数=67)、研究组(例数=64)，对照组患者进行常规护理方法，研究组患者在此基础之上，使用营养评估与专病一体化饮食指导帮助患者康复，在经过护理干预的3 个月之后，对比白蛋白水平、营养状况及生活质量。结果在2 组患者都经过3 个月的护理以后，研究组患者营养状况优于对照组，具有统计学意义(t=27.729，P＜0.001)；在2 组患者都经过3 个月的治疗以后，观察组躯体、精神、生活质量综合评分高于对照组(t 值分别为18.198, 27.861, 16.603；P值分别为＜0.001, ＜0.001，＜0.001)；经过3 个月护理干预治疗之后，研究组患者满意度明显高于对照组(t=8.092，P=0.004)。结论在肾病患者的血液透析治疗中，营养评估与专病一体化饮食指导的应用效果明显，能够改善患者营养状况，提高患者的生活质量。

【Abstract】Objective The purpose of this article was to analyze the effect of nutritional assessment and integrated dietary guidance during dialysis nursing on hemodialysis patients. Methods A total of 131 hemodialysis patients treated in the Department of Nephrology, Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine during the period from November 20, 2017 to November 15, 2019 were enrolled in this study. They were randomly divided into control group (n=67), in which patients were treated with conventional nursing method, and study group (n=64), in which patients were treated with nutrition assessment and integrated dietary guidance in addition to the conventional nursing method. After the intervention for 3 months, malnutrition-inflammation score (MIS score), health status questionnaire (SF-36) score and dietary instruction satisfaction were compared between the two groups. Results After the intervention for 3 months, MIS and SF-36 scores were better in study group than in control group (t=27.729, P＜0.001). The overall scores of body, consciousness, and quality of life were higher in study group than in control group (t=18.198, 27.861 and 16.603 respectively; P＜0.001). The satisfaction degree was also higher in study group than in control group (t=8.092, P=0.004). Conclusion The nutrition assessment and special disease dietary guidance during dialysis nursing can improve nutritional status and quality of life in hemodialysis patients.