基于微型营养评定法的营养评估及干预在老年住院慢性病患者中的应用
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摘要
目的通过微型营养评定法(MNA)评价老年住院慢性病患者营养状况,探讨营养支持及护理干预在老年住院慢性病患者中的应用效果。方法选取慢性病患者54例,运用MNA进行营养评估,根据评估结果对于存在营养风险的患者给予营养支持和护理干预,比较干预前及干预后第2周MNA分值及日常生活能力评估分值(Barthel指数)、血清白蛋白(ALB)、前白蛋白(PAB)、血红蛋白(HGB)、体质指数(BMI)、上臂围、小腿围、患者利手握力等变化。结果运用MNA对住院老年慢性病患者进行营养风险评估并给予个性化营养支持与护理方案,结果显示:干预前后MNA总分、Barthel指数、PAB、利手握力、BMI、上臂围、小腿围结果比较差异均有统计学意义(P <0. 05)。营养总风险率由干预前68. 52%下降到干预后46. 29%。结论 MNA可及时发现老年住院慢性病患者存在的营养风险,有利于临床针对性的采取相应的营养支持与护理干预措施,可以降低住院老年慢性病患者的营养风险,提高老年住院慢性病患者的生活质量。
Objective To appraise the nutritional status of hospitalized elderly patients with chronic disease by mini nutritional assessment( MNA),and to investigate the effect of nutritional support and nursing intervention on nutritional risks of hospitalized elderly patients with chronic disease. Methods Fifty hospitalized elderly patients with chronic disease were selected for nutritional assessment using MNA,and nutritional support and nursing intervention were given to patients with nutritional risk according to the assessment results. Then the MNA,Barthel,ALB,PAB,HGB,BMI,arm girth,calf circumference and hand grip strength of patients before and 2 weeks after intervention were compared. Results MNA total score,Barthel index,PAB,handiwork strength,BMI,upper arm circumference and calf circumference before and after the intervention were statistically significant( P < 0. 05). The rate of nutritional risks fell to 46. 29 percent after intervention from 68. 52 percent before intervention. Conclusion MNA can timely detect the nutritional risks of hospitalized elderly patients with chronic disease,which is conducive to the clinical targeted adoption of corresponding nutritional support and nursing intervention measures,and can reduce nutritional risks of hospitalized elderly patients with chronic disease and improve the quality of life for patients of elderly inpatients with chronic diseases..
Objective To appraise the nutritional status of hospitalized elderly patients with chronic disease by mini nutritional assessment( MNA),and to investigate the effect of nutritional support and nursing intervention on nutritional risks of hospitalized elderly patients with chronic disease. Methods Fifty hospitalized elderly patients with chronic disease were selected for nutritional assessment using MNA,and nutritional support and nursing intervention were given to patients with nutritional risk according to the assessment results. Then the MNA,Barthel,ALB,PAB,HGB,BMI,arm girth,calf circumference and hand grip strength of patients before and 2 weeks after intervention were compared. Results MNA total score,Barthel index,PAB,handiwork strength,BMI,upper arm circumference and calf circumference before and after the intervention were statistically significant( P < 0. 05). The rate of nutritional risks fell to 46. 29 percent after intervention from 68. 52 percent before intervention. Conclusion MNA can timely detect the nutritional risks of hospitalized elderly patients with chronic disease,which is conducive to the clinical targeted adoption of corresponding nutritional support and nursing intervention measures,and can reduce nutritional risks of hospitalized elderly patients with chronic disease and improve the quality of life for patients of elderly inpatients with chronic diseases..
引文
[1]张茹欣.以奥马哈系统为框架的老年慢性病营养不良患者延续护理模式构建与应用[D].广州:南方医科大学,2014.
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[6]唐大年,韦军民,朱明炜,等.老年住院患者营养风险、营养不足发生率及营养支持应用状况的调查[J].中华老年医学杂志,2011,30(11):974-976.
[7]孙嘉,郑晶晶,郭松文,等.微型营养评定法在老年慢性阻塞性肺疾病患者中的应用及其与BODE指数的相关性[J].南方医科大学学报,2013,33(8):1217-1220.
[8]中国老年医学会.老年医学(病)科临床营养管理指导意见[J].中国老年医学杂志,2015,34(12):1388-1395.
[9]高纯,胡俊波.临床营养筛查与评估方法的现状与进展[J].临床外科杂志,2016,24(12):896-898.
[10]王庆华,王志莲,王霞,等应用微型营养评价法对消化系统肿瘤病人的营养评价[J].护理研究,2006,20(3):615-616.
[11]蒲虹杉,董碧蓉.老年相关疾病与营养不良[J].肠外与肠内营养,2013,3(20):123-128.
[12]徐晓峰,王珊,王茜,等.营养干预对老年代谢综合征影响的对照研究[J].中华全科医学,2010,8(7):875-876.
[2]李玉静.老年人慢性病患病现状及其影响因素分析[D].唐山:河北联合大学,2015.
[3] OLIVEIRA M R,FOGACA K C,LEANDRO-MERHI V A. Nutritional status and functional capacity of hospitalized elderly[J]. Nutr J,2009,8:54.
[4]饶志勇,胡雯,袁红,等.微型营养评价法评价慢病住院老人的营养状况[J].现代预防医学,2008,35(4):673-675.
[5]崔丽英,张澍田,于康,等.北京大医院住院患者营养风险、营养不良(不足)、超重和肥胖发生率及营养支持应用状况[J].中国临床营养杂志,2008,16(6):341-345.
[6]唐大年,韦军民,朱明炜,等.老年住院患者营养风险、营养不足发生率及营养支持应用状况的调查[J].中华老年医学杂志,2011,30(11):974-976.
[7]孙嘉,郑晶晶,郭松文,等.微型营养评定法在老年慢性阻塞性肺疾病患者中的应用及其与BODE指数的相关性[J].南方医科大学学报,2013,33(8):1217-1220.
[8]中国老年医学会.老年医学(病)科临床营养管理指导意见[J].中国老年医学杂志,2015,34(12):1388-1395.
[9]高纯,胡俊波.临床营养筛查与评估方法的现状与进展[J].临床外科杂志,2016,24(12):896-898.
[10]王庆华,王志莲,王霞,等应用微型营养评价法对消化系统肿瘤病人的营养评价[J].护理研究,2006,20(3):615-616.
[11]蒲虹杉,董碧蓉.老年相关疾病与营养不良[J].肠外与肠内营养,2013,3(20):123-128.
[12]徐晓峰,王珊,王茜,等.营养干预对老年代谢综合征影响的对照研究[J].中华全科医学,2010,8(7):875-876.