住院老年卧床患者个体化鼻饲匀浆膳的临床应用观察

Effects of self-prepared individualized homogeneous meals with natural ingredients on senile bedridden inpatients

目的:观察个体化配制自制匀浆膳对老年卧床鼻饲患者的营养支持效果。方法:对2008年8月-2009年12月在我院住院的32例年龄62～89岁的卧床老年鼻饲患者应用个体化匀浆膳,进行营养状况跟踪观察。观察1个月(排除治疗期间死亡、严重感染治疗失败、消化道大出血病例),比较应用个体化匀浆膳前后的营养摄入情况及治疗前和治疗1个月后血液中血红蛋白、总蛋白、白蛋白、前白蛋白、高密度脂蛋白-胆固醇水平。结果:个体化营养支持后的蛋白和碳水化合物的摄入有了明显提高,治疗后血红蛋白、总蛋白、白蛋白、高密度脂蛋白胆固醇(P<0.05)以及前白蛋白(P<0.01)均较治疗前显著升高。结论:膳食结构不合理会导致老年患者营养不良,老年患者营养支持应进行个体化调整,通常适宜使用高热量、高蛋白质、低脂肪、充足碳水化合物和维生素的营养配方。这种配方有助于纠正营养不良,增强抗病能力,配合临床治疗,降低病死率。

Objective To study the effects of nasal feeding of self prepared natural homogeneous meals on senile bedridden patients. Methods：During August 2008 to December 2009,the nutritional state of 32 senile patients aged 66-89 year-old were observed. Before and one month after using self-made natural homogeneous meals, nutritional status and blood biochemical examinations including hemoglobin, total protein, albumin, prealbumin and high density lipoprotein cholesterol of the patients were examined and compared. Results：After individualized nutritional support, protein and carbohydrate intake increased, and blood hemoglobin, total protein, albumin, high density lipoprotein cholesterol （P〈0. 05） and prealbumin （P〈0.01） were increased significantly. No undue symptoms were observed. Conclusion：Unreasonable dietary regime may cause malnutrition in nasal-feeding bedridden senile patients. Nutritional support of senile patients should be individualized. Generally,a nutrition regime with high calorie, high protein, low fat, adequate carbohydrate and vitamins will improve malnutrition, increase body resistance, and decrease mortality.