80岁以上老年肺炎患者营养风险筛查及营养支持治疗应用分析

Nutritional assessment and nutritional interventions in the elderly inpatients aged over 80 with pneumonia

目的调查>80岁老年肺炎患者发生营养不良、营养风险的比例,了解接受营养支持治疗的比例及营养支持治疗的效果。方法将199例患者分为重症肺炎组及非重症肺炎组。采用营养风险筛查表(NRS2002)对患者进行营养风险筛查,体质量指数(BMI)<18.5或血清白蛋白<30 g/L评估为营养不良;NRS2002总分≥3分为存在营养风险;对存在营养不良及营养风险患者给予营养支持治疗。观察治疗28 d后血清白蛋白、前白蛋白及APACHEⅡ评分。结果 199例研究对象中有187例患者存在营养不良或营养风险,总发生比例为94.0%,其中营养不良和营养风险的发生比例分别为35.7%、58.3%。营养支持治疗28 d后血清白蛋白、前白蛋白水平与营养支持治疗前比较均升高,APACHEⅡ评分降低(P<0.05)。结论 >80岁老年肺炎患者发生营养不良及营养风险的比例较高;营养支持治疗可以改善患者的营养状况,为疾病的治疗带来益处。

Objective To assess the nutritional state and the effect of nutritional interventions of patient with pneumonia aged over 80. Methods 199 patients with pneumonia were divided into severe pneumonia group and pneumonia group. The international standard of Nutritional Risk Screening（ NRS,2002） was applied to assess the nutritional risks of elderly patients with pneumonia. Body mass index（ BMI） 〈18. 5 or serum albumin 〈30 g / L indicated under-nutrition,and the total score of NRS≥3 indicated the nutritional risk. Nutritional intervention were conducted in the patients who suffered from under-nutrition or had nutritional risks. Serum albumin,prealbumin and APACHE Ⅱ grade were detected and compared before and 28 days after treatment. Results There were 187（ 94. 0%） elderly inpatients under-nutrition or with nutritional risk among 199 patients with pneumonia,and the rate of under-nutrition and nutritional risk was 35. 7%and 58. 3% respectively. After 28 days of nutritional interventions,serum albumin,prealbumin were higher than those before the treatment,and APACHE Ⅱ grade dropped（ P〈0. 05）. Conclusions The nutritional risks and under-nutrition are common in patients aged over 80 with pneumonia; nutritional interventions can improve the nutrition condition and support other treatment.