早期营养支持对酒依赖患者临床结局的影响

Effect of early nutritional support on clinic outcome for alcohol dependence

目的探讨营养支持对酒依赖患者临床结局的影响.方法选取2018年8月至2020年12月在河北医科大学第一医院精神卫生中心住院的酒依赖患者,使用营养风险筛查量表(NRS2002)对患者进行营养风险筛查.纳入存在营养风险的患者共116例(NRS≥3分).以患者是否接受营养支持分为营养支持组(70例)和无营养支持组(46例),比较两组患者的临床转归与并发症状况.结果营养支持组的震颤谵妄平均持续时间为(51.32±9.93)h,低于无营养支持组的(60.06±13.14)h,差异有统计学意义(t=-2.290,P=0.028).入院第3天和第7天,营养支持组的日常生活能力(ADL)评分[(89.71±16.83)、(94.43±11.60)分]均高于无营养支持组[(80.54±21.51)、(88.37±14.61)分],差异有统计学意义(F=6.955,P=0.012;F=6.153,P=0.015).营养支持组的并发症发生率为21.4%(15/70),低于无营养支持组的39.1%(18/46),差异有统计学意义(χ^(2)=4.273,P=0.039).结论营养支持可减轻酒精戒断反应程度,缩短震颤谵妄的持续时间,促进生活能力恢复,同时可以减少感染、压疮、跌伤等并发症的发生风险.

Objective To investigate the effect of nutritional support on prognosis of alcohol dependent patient.Methods Alcohol dependent patients hospitalized in Mental Health Center of the First Hospital of Hebei Medical University from August 2018 to December 2020 were selected. The nutritional risk screeningscale (NRS2002) was used to screen the nutritional risk of the patients. A total of 116 patients with nutritionalrisk (NRS≥3) were included. The patients were divided into nutritional support group (n=70) and non nutritionalsupport group (n=46). The clinical outcomes and complications were compared between the two groups.Results The average duration of delirium in nutritional support group [(51.32±9.93)h] was lower than thatin non nutritional support group [(60.06±13.14)h]. The difference was statistically significant (t=-2.290,P=0.028). The Activities of Daily Living (ADL) scores of the nutritional support group on the 3rd and 7th dayafter admission [(89.71±16.83),(94.43±11.60)] were higher than those of the non nutritional support group[(80.54±21.51),(88.37±14.61)]. The difference was statistically significant (F=6.955, P=0.012;F=6.153,P=0.015). The complication rate of nutritional support group was 21.4% (15/70), which was lower than thatof non nutritional support group [39.1% (18/46)]. The difference was statistically significant (χ^(2)=4.273,P=0.039). Conclusions Nutritional support can reduce alcohol withdrawal reaction, shorten the duration ofdelirium, promote the recovery of life ability, and reduce the complications of infection, pressure sores, fallsand other complications.