营养风险筛查联合个性化营养方案对失代偿期肝硬化患者的影响
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摘要
目的通过营养风险筛查联合个性化营养方案改善失代偿期乙肝肝硬化患者的营养状况。方法选取2016年1—12月收治于华中科技大学同济医学院附属同济医院的失代偿期乙肝肝硬化患者80例,随机分为观察组(n=40)和对照组(n=40)。对照组给予常规治疗,观察组在此基础上给予营养风险筛查联合个性化营养方案治疗。比较入组时和干预3个月后两组患者的体质量指数(BMI)、肱三头肌皮褶厚度、上臂肌围等营养参数指标,以及血蛋白指标、肝功能和主观全面营养状况评价等级情况。结果治疗3个月后,观察组患者的各项营养参数、血蛋白指标及肝功能指标均优于对照组(P<0.05)。结论营养风险筛查联合个性化营养方案可有效改善失代偿期乙肝肝硬化患者的营养不良状态,促进其肝功能恢复。
Objective To discuss the effect of nutritional risk screening combined with individualized nutrition program on the nutritional status of patients with decompensated hepatitis B cirrhosis. Methods A total of 80 patients with decompensated hepatitis B cirrhosis admitted to Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from January to December 2016 were selected.They were randomly divided into the observation group and control group with 40 cases in each group. The control group was treated with routine treatment, while the observation group was treated with additional nutritional risk screening combined with individualized nutrition program. Body mass index(BMI), tricep skinfold thickness, mid-arm muscle circumference and other nutritional parameters were compared between the two groups at admission and 3 months after intervention, as well as blood protein index, liver function and subjective comprehensive nutritional status. Results After 3 months of treatment, the nutritional parameters,serum proteins and liver function in the observation group were better than those in the control group(P<0.05). Conclusions Nutritional risk screening combined with individualized nutrition program can effectively improve the malnutrition status of patients with decompensated hepatitis B cirrhosis and promote the recovery of liver function.
Objective To discuss the effect of nutritional risk screening combined with individualized nutrition program on the nutritional status of patients with decompensated hepatitis B cirrhosis. Methods A total of 80 patients with decompensated hepatitis B cirrhosis admitted to Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from January to December 2016 were selected.They were randomly divided into the observation group and control group with 40 cases in each group. The control group was treated with routine treatment, while the observation group was treated with additional nutritional risk screening combined with individualized nutrition program. Body mass index(BMI), tricep skinfold thickness, mid-arm muscle circumference and other nutritional parameters were compared between the two groups at admission and 3 months after intervention, as well as blood protein index, liver function and subjective comprehensive nutritional status. Results After 3 months of treatment, the nutritional parameters,serum proteins and liver function in the observation group were better than those in the control group(P<0.05). Conclusions Nutritional risk screening combined with individualized nutrition program can effectively improve the malnutrition status of patients with decompensated hepatitis B cirrhosis and promote the recovery of liver function.
引文
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[11]周丹丹,朱宝华,张蓓蓓,等.慢性阻塞性肺疾病急性发作并发呼吸衰竭病人的营养风险筛查及预后分析[J].肠外与肠内营养,2014,21(3):158-160.
[12]杨淑梅,贾莉,张凤琴,等.个体化营养干预改善血液透析患者蛋白质能量消耗及生存质量的研究[J].临床肾脏病杂志,2017,17(11):658-662.
[13]张敏,郭放,付莉,等.消化内科住院患者营养风险筛查及分析[J].中华现代护理杂志,2013,19(8):902-904.
[14]宣琪,张育先,刘殿刚,等.术前个体化营养治疗改善胃肠道肿瘤患者营养状态观察[J].中国临床医生杂志,2017,45(3):73-76.
[15]王代宏,王芳元,王伟,等.原发性肝癌手术前后营养风险筛查及临床分析[J].临床外科杂志,2013,21(12):933-936.
[2]AHN S H,CHUN J Y,SHIN S K,et al.Performance evaluation of the HepB Typer-Entecavir kit for detection of entecavir resistance mutations in chronic hepatitis B[J].Clin Mol Hepatol,2013,19(4):399-408.
[3]潘乐,张娜,任慧燕,等.肝硬化病人营养状况评估的研究进展[J].护理研究,2017,31(9):1034-1035.
[4]袁翠莲,杨云珍,楼娜飞.个体化饮食管理对血透营养不良患者营养状况和生活质量的影响[J].全科医学临床与教育,2015,13(4):471-473.
[5]ZOULIM F,CAROSI G,GREENBLOOM S,et al.Quantification of HBsAg in nucleos(t)ide-na觙ve patients treated for chronic hepatitis B with entecavir with or without tenofovir in the BE-LOWstudy[J].J Hepatol,2015,62(1):56-63.
[6]何继荣,马飞月.简易营养评价精法在老年脑卒中患者营养状况评估中的应用[J].中国卫生标准管理,2016,7(19):2-4.
[7]程雪花,沈震,徐丽萍,等.肝硬化患者自我护理能力和生存质量的相关性研究[J].上海护理,2016,16(4):37-40.
[8]PENG C Y,HSIEH T C,HSIEH T Y,et al.HBV-DNA level at 6months of entecavir treatment predicts HBeAg loss in HBeAgpositive chronic hepatitis B patients[J].J Formos Med Assoc,2015,114(4):308-313.
[9]TURYADI,THEDJA M D,IE S I,et al.HBsAg,HBeAg and HBVDNA level changes and precore/basal core promoter mutations in the natural history of chronic hepatitis B in Indonesian patients[J].Hepatol Int,2013,7(4):969-980.
[10]丁沛,罗宏伟,徐玉玲.基于肝病实脾理论研究健脾运脾法对肝硬化失代偿期患者营养状态的影响[J].中国中医急症,2016,25(5):910-912.
[11]周丹丹,朱宝华,张蓓蓓,等.慢性阻塞性肺疾病急性发作并发呼吸衰竭病人的营养风险筛查及预后分析[J].肠外与肠内营养,2014,21(3):158-160.
[12]杨淑梅,贾莉,张凤琴,等.个体化营养干预改善血液透析患者蛋白质能量消耗及生存质量的研究[J].临床肾脏病杂志,2017,17(11):658-662.
[13]张敏,郭放,付莉,等.消化内科住院患者营养风险筛查及分析[J].中华现代护理杂志,2013,19(8):902-904.
[14]宣琪,张育先,刘殿刚,等.术前个体化营养治疗改善胃肠道肿瘤患者营养状态观察[J].中国临床医生杂志,2017,45(3):73-76.
[15]王代宏,王芳元,王伟,等.原发性肝癌手术前后营养风险筛查及临床分析[J].临床外科杂志,2013,21(12):933-936.