住院老年多发性脑梗死患者不同进食方式下营养状况及其影响因素

Study on nutritional status of hospitalized elderly patients with multiple cerebral infarction under different eating styles and influencing factors

目的研究住院老年多发性脑梗死患者在经口进食及鼻饲饮食2种方式下营养状况的差异,并调查影响患者营养状况的因素。方法纳入安徽省合肥市某三甲医院100例老年多发性脑梗死患者,对其进行性别、年龄、进食方式、吞咽功能、锻炼情况、受照顾程度、疾病史等一般资料的调查,检测白蛋白、前白蛋白、血红蛋白、肌酐等血液学指标,并应用微型营养评价精法(MNA-SF)对研究对象进行营养评分。结果纳入患者中总营养风险发生率为78%,经口进食组营养风险发生率高于鼻饲饮食组,且经口进食人群整体营养评分低于鼻饲饮食人群,差异有统计学意义(t=-2.456,P=0.016)。经口进食组整体白蛋白(t=-2.257,P=0.026)及血红蛋白(t=-3.261,P=0.002)水平均低于鼻饲组,差异有统计学意义。MNA-SF评分与白蛋白(r=0.534,P<0.001)、血红蛋白(r=0.521,P<0.001)中度正相关,与前白蛋白(r=0.368,P<0.001)、肌酐(r=0.219,P=0.028)低度正相关。多因素分析显示是否患有糖尿病、锻炼频率、受照顾程度是营养状况的主要影响因素。结论老年人营养风险发生率高,对于有留置胃管指征的人群可考虑鼻饲饮食,降低营养风险。

Objective To study the difference in nutritional status of hospitalized elderly patients with multiple cerebral infarction under the two modes of oral feeding and nasal feeding,and to investigate the factors affecting the nutritional status of patients.Methods One hundred elderly patients with multiple cerebral infarction were randomly enrolled from a tertiary hospital in Hefei City,Anhui Province.They were surveyed with general data such as gender,age,eating style,swallowing function,exercise status,degree of care,disease history and tested for albumin,Prealbumin,hemoglobin,creatinine and other hematological indicators,and use the MNA-SF scale to score the nutrition of the study subjects.Results The incidence of total nutritional risk among the included patients was 78%.The incidence of nutritional risk in the oral feeding group was higher than that in the nasal feeding group,and the overall nutritional score of the oral feeding group was lower than that of the nasal feeding group,the difference was statistically significant(t=-2.456,P=0.016).The overall albumin(t=-2.257,P=0.026)and hemoglobin(t=-3.261,P=0.002)levels of the oral group were lower than those of the nasal feeding group,and the difference was statistically significant.MNA-SF score is moderately positively correlated with albumin(r=0.534,P<0.001)and hemoglobin(r=0.521,P<0.001),and positively correlated with prealbumin(r=0.368,P<0.001)and creatinine(r=0.219,P=0.028).Multivariate analysis showed that diabetes,exercise frequency,and degree of care were the main factors affecting nutritional status.Conclusions The incidence of nutritional risk in the elderly is high.For those with indwelling gastric tube indications,nasal feeding can be considered to reduce nutritional risk.