某三甲医院生活品质促进单元老年住院患者营养状况及其影响因素研究

Study on nutritional status and influencing factors of elderly inpatients in life quality promotion unit of a class 3A hospital

目的应用营养综合筛查评定了解老年生活品质促进单元中老年住院患者的营养状况现状及其影响因素分析,为下一步多学科诊疗中营养治疗提供基础。方法对纳入单元的老年住院患者,采用24 h膳食回顾、体格测量、实验室检查、临床查体以及微型营养评定(MNA-SF)对老年人进行营养状况评定,并进行分析。结果老年住院患者营养不良发生率为18.44%,营养风险发生率为45.39%,营养状况正常36.17%。对3组不同营养状况组进行比较分析,前清蛋白(PAB)、血红蛋白(HB)、清蛋白(ALB)、实际能量摄入与实际蛋白摄入,营养正常组高于营养风险及营养不良组,且差异均有统计学意义(P<0.05)。膳食调查结果显示,摄入量为4184(3347~5125)kJ,其中男性为4602(3713~5439)kJ,女性为3766(2929~4602)kJ;蛋白质摄入量为40(30~50)g,其中男性为42(35~50)g,女性为40(30~50)g,均低于其日常需要量。对可能影响营养状况的因素进行Logistic回归分析,发现ALB对其影响具有统计学意义。结论老年患者营养风险及营养不良的发生率较高。

Objective To apply the nutritional comprehensive screening to evaluate and understand the nutritional status of middle age and elderly inpatient in the life quality promotion unit and its influencing factors to provide a basis for the nutrition treatment in the next step multidisciplinary diagnosis and treatment.Methods The 24 h dietary recall,physical measurement,laboratory detection,clinical examination and MNA-SF were adopted to conduct the nutritional evaluation on the included elderly inpatients in the unit and analysis.Results The incidence rates of malnutrition,nutrition risk and normal nutrition status in elderly inpatients were 18.44%,45.39%and 36.17%respectively.In conducting the comparison analysis on 3 different nutritional status groups,prealbumin(PAB),hemoglobin(HB),albumin(ALB),actual energy intake and actual protein intake in the nutrition normal group were higher than those in the nutritional risk group and malnutritional group,and the differences were statistically significant(P<0.05).The diet survey results showed that the energy intake was 4184(3347-5125)kJ,in which 4602(3713-5439)kJ for male and 3766(2929-4602)kJ for female,the protein intake was 40(30-50)g,in which 42(35-50)g for male and 40(30-50)g for female,and all were lower than the daily requirement amount.The Logistic regression analysis on the factors possibly affecting the nutritional status found that ALB had the statistical significance.Conclusion The incidence rate of nutritional risk and malnutrition in elderly patients is high.