脑卒中患者营养评估的作用

Effect of Nutrition Estimating of Patients with Stroke

目的对脑卒中患者不同时期进行营养评估,并分析营养评估的作用。方法收集我院急性脑卒中患者60例,均进行营养风险筛查评分,检测营养学的指标来评定其营养状况,对存在营养风险和营养不良的患者均进行常规脑卒中治疗和营养支持,在住院14d、28d后再进行营养风险评分和相应指标的检测,分析营养风险评分与营养评价指标的检测在临床工作中的作用。结果60例卒中患者,入院时评定有营养风险者15例;营养不良发生率为13.3%;营养不良患者年龄明显高于营养正常者(P<0.01);14d后营养不良发生率为18.3%;28d后经营养支持后营养不良的发生率降至6.7%,各项营养学的指标均有所改善(P<0.05)。结论卒中患者在住院期间可能发生营养状况恶化,早期及定期对患者进行营养评估均有必要。营养风险筛查评分能简单反映住院患者的营养状况,并能预测营养不良的风险,但对于昏迷、瘫痪及难以准确测量体重指数(BMI)的患者,使用受到限制。在临床仍常采用人体测量和生化指标确定患者是否营养不良。本文认为卒中患者均需进行营养风险评估和营养不良的确定,作为进行合理营养支持的依据和指导。

Objective To evaluate the effect of nutrition estimating on patients with stroke at different phase. Methods A total of 60 patients with acute stroke of less than 24 h duration were included in the study. Nutrition risk screening was done in all those patients, with nutritional parameters to evaluate their nutritional status. Nutritional parameters were evaluated at admission and after 14, 28 d after the stroke, respectively. Results We found 15 cases with nutrition risk of 60 patients in admission, and incidence rate of undernutrition is 13.3%. Age of abnormal nutrition group was obviously higher than normal nutrition group （P〈0.01）. The incidence rate of under-nutrition was 18.3% after 14 d; and that was 6.7% after 28 d, and each nutritional parameter was improved with the routine treatment （P〈0.05）. Conclusion The nutriture deterioration may occur following acute stroke. It is necessary for patients to do nutrition estimating in early phase and periodic. Nutrition risk screening can simply reflex the nutrition statue of patients, and predict of the risk of under-nutrition. But the application of nutrition estimating was limited in patients with coma, and palsy, and that hard to examine BMI exactly. We usually use physical examination and blood test to determine dystrophy. We think the stroke patients should be nutrition risk screening and Nutrition Assessment, It helps the patients get reasonable support of nutrition.