摘要
目的:探讨补充β-羟基-β-丁酸甲酯(HMB)对老年髋关节置换病人跌倒风险的干预效果。方法:选取≥65岁、非髋部骨折拟行单侧髋关节置换术的病人,随机分为试验组和对照组。对照组参照2013年《中国居民膳食营养素参考摄入量》并结合病人自身营养状况和手术需求进行饮食指导和营养支持,并按髋关节置换术后康复方案进行有效功能锻炼。试验组在对照组基础上,增加HMB的摄入。补充方案为:体重≤68 kg,补充HMB 2g/d;体重>68 kg,补充HMB 3 g/d,干预时间为6个月。分别在术后第12周和第24周进行下肢肌肉力量测试-站起测试(CRT)和计时起立行走测试(TUGT),并计算相应的跌倒风险,记录跌倒发生情况。结果:试验组、对照组术后第12周CRT分别为(14.91±4.34),(16.51±3.73),差异有统计学意义(P<0.05);TUGT分别为(16.95±4.18),(18.47±3.13),差异有统计学意义(P<0.05);跌倒高风险比例分别为95.5%和98.2%(P<0.05)。试验组、对照组术后第24周CRT分别为(14.27±3.99),(16.49±3.56),差异有统计学意义(P<0.05);TUGT分别为(16.51±3.85),(18.11±3.18),差异有统计学意义(P<0.05);跌倒高风险比例分别为81.8%和94.5%(P<0.05)。术后24周内试验组无跌倒发生,对照组有4例病人发生跌倒(P<0.05)。结论:补充HMB并配合有效的功能训练可提高THA老年病人的的下肢肌肉力量和平衡力,从而降低老年髋关节置换病人的跌倒风险。
Objective: To investigate the effect of beta-hydroxyl-beta-methyl butyrate(HMB) supplementation on fall risk in elderly patients receiving total hip arthroplasty(THA). Method: Patients with non-hip fracture who are older than 65 years old and intend to receive unilateral THA were randomly divided into trial group and control group. In addition to consideration of patients' nutritional status and surgical needs, patients in the control group were provided dietary guidance and nutritional support according to the reference intake of dietary nutrients of Chinese residents in 2013. Effective functional exercise was taken by each patient according to the rehabilitation plan after THA. Patients in the trial group were given additional HMB based on the nutritional management plan of the control group. The methods of HMB supplementation was as follows: weight ≤ 68 kg, supplemented with HMB 2 g/d; weight 68 kg, supplemented with HMB 3 g/d, intervention time is 6 months. To evaluate the fall risks and to collect the data of fall incidence, chair rising test(CRT), timed up, and go test(TUGT) were taken12-and 24-weeks after surgery, respectively. Result: The CRT was(14.91 ± 4.44) and(16.51 ± 3.73) in the trial group and in the control group 12-week after surgery(P〈0.05); while the TUGT was(16.95 ± 4.18) and(18.47 ± 3.13), respectively(P〈0.05). The risk ratio of fall was 95.5% and 98.2% in the trial and control group(P〈0.05). At the 24-week after surgery, the CRT was(14.27 ± 3.99) and(16.49 ± 3.56) in the trial group and in the control group(P〈0.05); while the TUGT was(16.51 ± 3.85) and(18.11 ± 3.18),respectively(P〈0.05). The risk ratio of fall was lower in the trial group compared that in the control group(81.8% vs94.5%,P〈0.05). There was no fall incidence in the trial group, however, this was seen in 4 cases in the control group(P〈0.05) during the 24-week period of follow-up. Conclusion: HMB supplementation combined with effective functional training can improve the muscle strength and the balance of the lower limbs of the elderly patients with THA, which is associated with the decreased incidence of fall risks.
作者
张玉梅
何洁
冯筱青
张瑗
ZHANG Yu-mei;HE Jie;FENG Xiao-qing;ZHANG Yuan(Department of Orthopaedics,The Second Affiliated Xinqiao Hospital of Army Medical University,Chongqing 400037,China)
出处
《肠外与肠内营养》
北大核心
2018年第4期218-222,共5页
Parenteral & Enteral Nutrition
基金
重庆市基础与前沿计划研究项目(cstc2014jcyja10124)