高龄老年患者营养风险、营养不足发生率及营养支持的调查研究

Nutritional risk, malnutritional incidence and nutritional support of elderly patients:a survey

目的调查高龄老年患者营养风险、营养不足发生率及营养支持的现状,为进一步实施有效的营养干预措施提供依据。方法采用便利抽样法,对2015年12月至2017年6月在本院5个老年病区住院的358例高龄老年患者进行调查,了解患者营养风险、营养不足及营养支持应用状况。结果总营养风险发生率为50.3%(180/358),营养风险发生率较高的疾病依次是代谢类疾病、消化系统疾病、肿瘤、神经系统疾病等。总营养不足发生率为36.0%(129/358),营养不足发生率较高的疾病依次是肿瘤、消化系统疾病、神经系统疾病、代谢类疾病等。358例患者中,共有134例患者(37.4%)接受营养支持,其中肠内营养(enteral nutrition,EN)57例(42.5%),肠外营养(parenteral nutrition,PN)77例(57.5%),PN/EN比值为1.35:1。结论高龄老年患者总营养风险发生率、营养不足发生率较高。营养支持的临床应用虽较前有所提升,但仍存在一定的不合理性,本研究对EN合理应用及认识较全国平均水平高。

Objective To investigate the prevalence of nutritional risk, malnutritional incidence among elderly patients and nutritional support for them so as to provide the basis for the implementation of effective care interventions. Methods 358 elderly patients from 5 geriatric wards in a tertiary hospital were consecutively enrolled from December 2015 to June 2017 by convenience sampling to look into the status of nutritional risk, malnutrition and nutritional support. Results Overall prevalence of nutritional risk was 50.3%. The diseases with higher incidence of nutritional risk were metabolic disorder, digestive system disease, tumor, nervous system disease and so on. The overall incidence of malnutrition was 36.0%. The diseases with higher incidence of malnutrition were tumor, digestive system disease, nervous system disease, metabolic disorder and so on. Of the 358 patients, 134 ones （37.3%） received nutritional support. 77 （57.5%） of them received parenteral nutrition （PN） and 57 （42.5%） of them received enteral nutrition （EN）, with PN/EN ratio of 1.35：1. Conclusions The overall incidences of nutritional risk and malnutrition in the hospitalized elderly patients are at a high level. Although the clinical application of nutritional support has been improved, there is still a certain degree of irrationality. In this study the clinical application of the rational use of enteral nutrition is better than the national norm.