MISA评估对高龄患者营养和压力性损伤的影响

The Effect of MISA Assessment on Nutritional and Stress Injuries in Elderly Patients

目的探讨摄食技能评估对老年科高龄(≥80岁)住院患者营养风险和压力性损伤风险评估的指导作用。方法选取我院老年医学科高龄患者52例作为研究对象,将其随机均分为对照组与观察组,每组各26例。对照组给予老年患者常规营养指导护理,观察组在对照组基础上,应用麦吉尔摄食技能评估问卷(MISA)动态评估患者营养治疗过程中的功能性摄食能力,针对性实施营养支持干预。干预8周,对比两组患者营养风险筛查状况(MNA评分)、压力性损伤风险评估(Waterlow)及非预期压力性损伤风险发生情况。结果干预前,两组MNA评分和Waterlow评分比较,差异无统计学意义(P>0.05);干预后,观察组MNA评分高于对照组,观察组Waterlow评分低于对照组,差异具有统计学意义(P<0.05)。干预周期内,观察组非预期压力性损伤发生率(7.69%)低于对照组的30.77%,差异具有统计学意义(χ2=4.457,P=0.035<0.05)。结论摄食技能评估对高龄患者营养支持治疗起到动态指导作用,有效改善了高龄患者营养状况,降低了高龄患者营养不良和非预期压力性损伤发生的风险,提高了老年科照护水平。

Objective To explore the guiding role of feeding skill assessment in assessing the nutritional risk and stress injury risk of elderly patients (≥ 80 years old) in geriatrics. Methods A total of 52 elderly patients in the geriatrics department of our hospital were randomly divided into control group and observation group. The control group was given routine nutritional guidance nursing for elderly patients. The observation group used the McGill Ingestion Skills Assessment Questionnaire (MISA) to dynamically assess the functional feeding ability of patients during the nutritional treatment process, and targeted nutritional support intervention. After 8 weeks of intervention, the nutritional risk screening status (MNA score), stress damage assessment (Waterlow) and unexpected stress injury risk were compared between the two groups. Results Before the intervention, there was no significant difference between the two groups in MNA score and Waterlow score (P > 0.05). After the intervention, the MNA score of the observation group was significantly higher than that of the control group, and the Waterlow score of the observation group was significantly lower than that of the control group, the difference was statistically significant (P < 0.05). During the intervention period, the incidence of unanticipated stress injury in the observation group (7.69%) was significantly lower than that in the control group (30.77%), the difference was statistically significant (χ2=4.457, P=0.035 < 0.05). Conclusion Feeding skill assessment plays a dynamic guiding role in nutritional support treatment for elderly patients, effectively improving the nutritional status of elderly patients, reducing the risk of malnutrition and unanticipated stress injuries in elderly patients, and improving the level of geriatric care.