阜阳市老年复发型脑梗死患者的营养风险状况评估及影响因素分析

Nutritional risk assessment and influencing factor analysis of elderly patients with recurrent cerebral infarction in Fuyang city

目的评估阜阳市老年复发型脑梗死患者的营养风险状态特点,分析影响营养风险的相关因素。方法选取2020年1月至2021年12月阜阳市人民医院收治的241例脑梗死患者作为研究对象,根据既往是否发生脑梗死分为初发型(n=45)和复发型(n=196)。采用营养风险筛查量表2002(NRS-2002)对初发型和复发型患者进行营养风险筛查,分为存在营养风险组(n=93)和无营养风险组(n=103);收集并比较两组患者一般资料、基础状况、脑梗死特征、临床症状和营养指标等数据。比较存在营养风险组和无营养风险组患者住院时间之间差异,同时采用单因素和多因素logistic分析的方法分析影响患者营养风险的相关因素。结果241例患者中,45例(18.67%)为初发型脑梗死,196例(81.33%)为复发型脑梗死;NRS-2002量表分析结果显示,196例复发型脑梗死患者中93例存在营养风险,占比47.45%,高于初发型脑梗死患者的24.44%,差异有统计学意义(P<0.05)。存在营养风险组患者平均住院时间高于无营养风险组,差异有统计学意义(P<0.05);单因素分析结果显示,存在营养风险组和无营养风险组患者之间家庭照料、梗死次数、日常生活活动能力(ADL)评分、国立卫生院卒中量表评分(NIHSS)评分、吞咽功能以及清蛋白水平之间差异有统计学意义(P<0.05);多因素logistic分析结果显示,梗死次数≥3次、ADL评分<60分以及洼田饮水试验分级≥3级是影响患者营养风险的危险因素。结论阜阳市老年复发型脑梗死患者具有较高营养风险,可能延长平均住院时间,对于存在自理能力低下、吞咽功能异常以及多次梗死病史等危险因素的患者需要提高重视程度。

Objective To evaluate the nutritional risk status of elderly patients with recurrent cerebral infarction in Fuyang city of Anhui province,and to analyze the related factors affecting nutritional risk.Methods A total of 241patients with cerebral infarction admitted to our hospital from January 2021 to December 2021 were selected as the research objects,and were divided into primary cerebral infarction patients and recurrent cerebral infarction patients according to the occurrence of previous cerebral infarction.Nutritional risk screening scale 2002(NRS-2002)was used to screen primary and recurrent patients for nutritional risk,which was divided into nutritional risk group and non-nutritional risk group.The general information,basic condition,characteristics of cerebral infarction,clinical symptoms,and nutritional indicators of the patients were collected.The differences in hospital stay between patients with nutritional risk and non-nutritional risk were compared,and the factors affecting nutritional risk were analyzed by single factor and multivariate logistics analysis.Results Among 241 patients,45(18.67%)had primary cerebral infarction and 196(81.33%)had recurrent cerebral infarction.The results of NRS-2002 scale analysis showed that 93 of 196 patients with recurrent cerebral infarction had nutritional risk,accounting for 47.45%,higher than 24.44%of patients with primary cerebral infarction,the difference was statistically significant(P<0.05).The average length of hospital stay in the nutritional risk group was higher than those in the non-nutritional risk group,and the differences were statistically significant(P<0.05).Univariate analysis showed that there were differences in family care,number of infarcts,ADL score,NIHSS score,swallowing function and albumin level between the two groups(P<0.05).The results of multivariate logistics analysis showed that the number of infarction≥3,ADL score<60 and the water test grade≥3 were the risk factors affecting the nutritional risk of patients.Conclusions The elderly patients with recurrent cerebral infarction in Fuyang city have a high nutritional risk,which may prolong the average length of hospital stay.More attention should be paid to patients with low self-care ability,abnormal swallowing function and history of multiple infarcts.