营养风险筛查应用于临床老年糖尿病肾病患者营养评估的效果及价值
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摘要
目的:探讨营养风险筛查应用于临床老年糖尿病肾病患者营养评估中的临床疗效和价值。方法:将青海大学附属医院收治的糖尿病肾病老年患者共186例纳入研究,采用营养风险筛查和传统营养评价方法评估患者营养状况、应用效果及价值。结果:186例老年糖尿病肾病患者均接受营养风险筛查和一般营养状况评估,营养风险筛查评估方法显示56例存在营养不良风险,占30.11%;糖尿病肾病Ⅳ期营养不良风险发生率为51.52%、Ⅴ期发生率为70.59%,均显著高于Ⅲ期发生率,差别具有统计学意义(P<0.05);ALB水平低于30g/L者30例,占16.13%;BMI检查结果示营养不良者19例,占10.22%;相关性研究发现,营养风险筛查与BMI、ALB、PA、SCr具有相关关系(P<0.05)。结论:应用营养风险筛查评估糖尿病肾病老年患者营养状况,可有效评估患者早期存在营养不良风险,以便早期干预治疗,值得临床推广。
Objective To explore and study the clinical effiect and value of nutritional risk screening in the nutritional evaluation of elderly diabetic nephropathy patients. Method We chose 186 elderly patients with diabetic nephropathy as the study object,used the nutritional risk screening and traditional nutrition evaluation methods to evaluate the nutritional status of the patients and evaluate the effect and value of the application. Result Totally 186 cases take in the nutritional risk screening and general nutritional status assessment,there were 56 cases with malnutrition risk by the NRS 2002(30. 11%). The malnutrition risk rate of DN Ⅳ was 51. 52%,while DN Ⅴ was70. 59%,which were all higher than the DN Ⅲ,there were statistical discrepancy in them(P < 0. 05). There were 30 cases whose ALB level was less than 30 g/L(16. 13%) and 19 cases whose BMI suggesting malnutrition(10. 22%). Study found that nutritional risk screening was associated with BMI,ALB,PA and SCr(P < 0. 05). Conclusion The nutritional risk screening can be used to evaluate the nutritional status of the elderly patients with diabetic nephropathy,which can effectively evaluate the risk of malnutrition in the early stage of diabetic nephropathy.
Objective To explore and study the clinical effiect and value of nutritional risk screening in the nutritional evaluation of elderly diabetic nephropathy patients. Method We chose 186 elderly patients with diabetic nephropathy as the study object,used the nutritional risk screening and traditional nutrition evaluation methods to evaluate the nutritional status of the patients and evaluate the effect and value of the application. Result Totally 186 cases take in the nutritional risk screening and general nutritional status assessment,there were 56 cases with malnutrition risk by the NRS 2002(30. 11%). The malnutrition risk rate of DN Ⅳ was 51. 52%,while DN Ⅴ was70. 59%,which were all higher than the DN Ⅲ,there were statistical discrepancy in them(P < 0. 05). There were 30 cases whose ALB level was less than 30 g/L(16. 13%) and 19 cases whose BMI suggesting malnutrition(10. 22%). Study found that nutritional risk screening was associated with BMI,ALB,PA and SCr(P < 0. 05). Conclusion The nutritional risk screening can be used to evaluate the nutritional status of the elderly patients with diabetic nephropathy,which can effectively evaluate the risk of malnutrition in the early stage of diabetic nephropathy.
引文
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[8]朱亦清,施咏梅,任红,等.营养风险对慢性肾脏病患者预后的影响[J].中华全科医师杂志,2013,12(8):650-652.
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[10]杨兰兰,范凤燕,施丽丽,等.饮食营养护理对老年糖尿病肾病患者的干预作用[J].当代临床医刊,2017,30(4):3207-3208.
[11]孔建华,张洁,滑莹莹,等.营养风险筛查在老年糖尿病肾病患者营养评估中的应用[J].中国临床保健杂志,2017,20(1):58-60.
[12]胡敏.营养护理干预对老年糖尿病肾病患者临床转归的影响[J].中西医结合护理,2016,2(4):101-105.
[2]张瑜凌,王梦婧,俞苹,等.维持性血液透析患者饮食蛋白摄入与营养状况的相关研究[J].中华肾脏病杂志,2016,32(3):161-166.
[3]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,30(7):447-498.
[4]周宏伟,江红.慢性肾病患者低蛋白饮食认知及行为调查与分析[J].武警医学,2016,27(8):859-860.
[5]娄唯鸣,韩中霞.简易营养评价法在老年糖尿病病人营养状况评估中的应用[J].肠外肠内营养,2012,19(2):125-126.
[6]中华医学会.临床诊疗指南:肠外肠内营养学分册[M].北京:人民卫生出版社,2009:200.
[7]王秋梅,朱鸣雷,曾平,等.老年住院患者营养风险和营养治疗情况分析[J].中华老年医学杂志,2014,33(4):404-406.
[8]朱亦清,施咏梅,任红,等.营养风险对慢性肾脏病患者预后的影响[J].中华全科医师杂志,2013,12(8):650-652.
[9]李宛洋,雷敏,滑丽美.糖尿病肾病患者营养治疗的研究进展[J].临床误诊误治,2017,30(7):110-113.
[10]杨兰兰,范凤燕,施丽丽,等.饮食营养护理对老年糖尿病肾病患者的干预作用[J].当代临床医刊,2017,30(4):3207-3208.
[11]孔建华,张洁,滑莹莹,等.营养风险筛查在老年糖尿病肾病患者营养评估中的应用[J].中国临床保健杂志,2017,20(1):58-60.
[12]胡敏.营养护理干预对老年糖尿病肾病患者临床转归的影响[J].中西医结合护理,2016,2(4):101-105.