失代偿期酒精性肝硬化患者的营养风险筛查及影响因素分析

Nutritional risk screening and influencing factors in patients with decompensated alcoholic liver cirrhosis

目的探讨失代偿期酒精性肝硬化患者的营养风险状况,并分析相关影响因素。方法选取2020年3月至2021年3月济宁医学院附属医院收治的失代偿期酒精性肝硬化患者186例,收集患者的临床资料,并发放问卷对患者的营养风险、家庭关怀度、饮食行为进行调查。了解患者的营养风险状况,并分析相关影响因素。结果失代偿期酒精性肝硬化患者中110例有营养风险,76例无营养风险,营养风险发生率59.14%。有营养风险组的饮食行为得分、家庭关怀度得分为(30.99±7.17)分和(6.48±2.01)分,无营养风险组分别为(45.85±6.87)分和(7.90±1.67)分,有营养风险组的饮食行为得分、家庭关怀度得分均低于无营养风险组(P<0.05)。有营养风险组与无营养风险组在家庭月收入、职业、BMI方面比较,差异均无统计学意义(P>0.05)。与无营养风险组相比,有营养风险组中60~75岁和>75岁占比更高,初中及以下学历占比更低、非婚/离异占比更高,Child-Pugh B级和C级者占比更高、有门静脉高压、胸腔/腹腔积液、低蛋白血症占比更高,家庭关怀度<7分及饮食行为<35分占比均更低(P<0.05)。年龄>75岁、Child-Pugh C级,非婚/离异、有门静脉高压、有胸腔/腹腔积液、有低蛋白血症、家庭关怀度<7分、饮食行为<35分均是患者发生营养风险的危险因素(OR=1.669,1.417,2.305,1.338,1.296,1.605,1.315,1.617,P<0.05),学历大专及以上为保护性因素(OR=0.854,P<0.05)。结论失代偿期酒精性肝硬化患者普遍存在营养风险,营养不良发生率较高,年龄、门静脉高压、低蛋白血症、饮食行为、家庭关怀度等是患者营养状况的影响因素,临床应对高营养风险患者做好营养风险筛查与健康宣教,并尽早采取干预措施。

Objective To investigate the nutritional risk status of patients with decompensated alcoholic liver cirrhosis and the related influencing factors.Methods One hundred and eighty-six patients with decompensated alcoholic cirrhosis in our hospital were selected.The clinical data of the patients were collected,and a questionnaire was issued to investigate the nutritional risk,family care and dietary behavior of the patients.The nutritional risk status of patients and the relevant influencing factors were analyzed.Results Among the patients with decompensated alcoholic liver cirrhosis,110 cases with nutritional risk and 76 cases without nutritional risk.The incidence of nutritional risk was 59.14%.The scores of dietary behavior and family care in the nutrition risk group[(30.99±7.17)and(6.48±2.01)]were significantly lower than those in the non nutrition risk group[(45.85±6.87)and(7.90±1.67)],(P<0.05).There was no significant difference in family monthly income,occupation and BMI between the 2 groups(P>0.05).Compared with the non nutritional risk group,the nutritional risk group had higher proportions of people aged 60~75 and>75,unmarried/divorced ratio,Child Pugh grade B and C,with portal hypertension,pleural/peritoneal effusion and hypoproteinemia,a lower proportion of junior high school education and below and family care<7 and dietary behavior<35(P<0.05).Based on the analysis,age>75,Child Pugh grade C,unmarried/divorced ratio,portal hypertension,pleural/peritoneal effusion,hypoproteinemia,family care<7 points and dietary behavior<35 points were the risk factors of nutritional risk(OR=1.669,1.417,2.305,1.338,1.296,1.605,1.315,1.617,P<0.05).College degree or above was the protective factor(OR=0.854,P<0.05).Conclusion Nutritional risk is common in patients with decompensated alcoholic liver cirrhosis,and the incidence of malnutrition is high.Age,portal hypertension,hypoproteinemia,dietary behavior and family care are the influencing factors of nutritional status.Patients with decompensated alcoholic liver cirrhosis should be screened for nutritional risk,and intervention measures should be taken timely.