五阶梯治疗在老年营养不良患者中的应用分析

Application Analysis of Five-step Treatment in Elderly Patients with Malnutrition

目的分析营养不良老年患者中五阶梯治疗的具体应用。方法方便选取2017年8月-2018年9月该院所收治需住院治疗65岁以上的105例老年患者作为该次研究对象,将存在着营养风险患者46例随机分成两个研究小组,每个小组为23例。研究组采取五阶梯式治疗,基础组则为基础治疗。分析两组效果。结果通过NRS2002筛查可了解到,该106例住院的老年患者当中,≥4分的患者为46例,存在着营养不良风险,男女患者比例为26∶20例。通过MNA的营养评估可了解到:有37例患者可确定为营养不良,男女患者比例为20∶17例。经过膳食营养调查后可了解到:摄入营养素不足的患者为39例,男女患者比例为21、18例;摄入能量不足的患者为30例,男女患者比例为19、11例。研究组患者在入院后第1天生化检查指标评分结果即为:HGB血红蛋白(101.4±2.2)g/L、TRF转铁蛋白(2.3±1.8)g/L、PA前白蛋白(175.4±0.9)mg/L、ALB血清白蛋白(31.3±1.3)g/L、TP总蛋白(54±11)g/L,基础组患者存在着营养不良症状风险,但并非采取五阶梯式治疗,仅给予患者基础的营养宣教指导及家庭饮食调理等治疗方案。患者在入院后第1天生化检查各项临床指标评分结果为:HGB血红蛋白(113±1.5)g/L、TRF转铁蛋白(2.3±1.4)g/L、PA前白蛋白(174.9±1.8)mg/L、ALB血清白蛋白(32.2±1.2)g/L、TP总蛋白(52.4±1.7)g/L。从以上数据对比分析结果中可表明,组间比较数据分析差异无统计学意义(P>0.05);研究组患者在采取五阶梯式营养干预治疗10 d后,生化各项检查指标评分结果即为:HGB血红蛋白(119±1.7)g/L、TRF转铁蛋白(2.3±1.8)g/L、PA前白蛋白(212.5±1.6)mg/L、ALB血清白蛋白(35.2±1.3)g/L、TP总蛋白(58.3±1.7)g/L。基础组患者在住院10 d后,生化各项检查指标评分结果即为:HGB血红蛋白(118±1.7)g/L、TRF转铁蛋白(2.3±1.9)g/L、PA前白蛋白(176.5±1.2)mg/L、ALB血清白蛋白(31.3±2.6)g/L、TP总蛋白(52.8±1.4)g/L。从以上数据对比分析结果当中即可表明,研究组患者在治疗10 d后的生化检查指标评分方面,相比较基础组,研究组各项生化指标、生活质量各项临床指标的评分方面优势均较为突出,组间比较数据分析差异有统计学意义(t=5.241、2.197、7.687、3.684、4.658,P<0.004、0.01、0.003、0.01、0.002)。结论对于老年住院患者营养不良病症,采取5阶梯式治疗方法具有临床应用的可行性价值,能够在短时间内改善患者临床生化各项指标,有效调节患者自身的营养状况,改善生活质量,有助于患者早日疾病转归。

Objective To analyze the specific application of five-step treatment in elderly patients with malnutrition.Methods From August 2017 to September 2018, hospitalized elderly patients who were hospitalized for treatment of 65 years old and above were the basic subjects of this study. 46 patients with nutritional risk were randomly divided into two research groups. Each group has 23 cases. The study group took a five-step treatment and the basic group was a basic treatment. Analysis of the two groups of effects. Results According to the NRS2002 screening, among the 106 hospitalized elderly patients, 46 patients with ≥4 points had a risk of malnutrition, and the proportion of male and female patients was26∶20. According to the nutrition assessment of MNA, 37 patients can be identified as malnourished, and the proportion of male and female patients was 20∶17. After a dietary nutrition survey, we can learn that there were 39 patients with insufficient nutrient intake, 21∶18 patients with men and women, 30 patients with insufficient energy intake, and 19、11 patients with men and women. The results of the first day biochemical examination index of the patients in the study group were:HGB hemoglobin(101.4±2.2)g/L, TRF transferrin(2.3±1.8)g/L, and PA prealbumin(175.4±0.9) mg/L, ALB serum albumin(31.3±1.3)g/L, TP total protein(54±11)g/L, the basic group of patients have the risk of malnutrition symptoms, but not a fivestep treatment, only given Patient-based nutrition education guidance and family diet conditioning treatment programs. The clinical indicators of the first biochemical examination on the 1 st day after admission were: HGB hemoglobin(113±1.5) g/L,TRF transferrin(2.3±1.4) g/L, and PA prealbumin(174.9±1.8) mg/L, ALB serum albumin(32.2±1.2)g/L, TP total protein(52.4±1.7)g/L. From the above data comparison analysis results, it can be shown that there is no statistical analysis of the difference between the comparison data of the groups(P>0.05);the patients in the study group were treated with five-step nutritional intervention for 10 days, biochemical examination results of the index were: HGB hemoglobin(119±1.7)g/L, TRF transferrin(2.3±1.8) g/L, PA prealbumin(212.5±1.6) mg/L, ALB serum albumin(35.2±1.3) g/L, TP total protein(58.3±1.7)g/L.After 10 days of hospitalization, the scores of biochemical indicators were: HGB hemoglobin(118±1.7)g/L, TRF transferrin(2.3±1.9)g/L, and PA prealbumin(176.5±1.2)mg/L, ALB serum albumin(31.3±2.6)g/L, TP total protein(52.8±1.4) g/L. From the above data comparison analysis results, it can be shown that the scores of the biochemical examination indicators of the patients in the study group were compared with those of the basic group, the biochemical indicators of the study group, and the clinical indicators of the quality of life were significant, the difference in data analysis between groups has statistical significance(t=5.241, 2.197, 7.687, 3.684, 4.658, P<0.004, 0.01, 0.003, 0.01, 0.002). Conclusion For the elderly patients with malnourished diseases, the five-step treatment method has the feasibility of clinical application. It can improve the clinical biochemical indicators of patients in a short period of time, effectively regulate the patient’s own nutritional status and improve the quality of life, to help patients with early disease outcomes.