论著

老年脑卒中后患者营养风险筛查研究

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  • 1.上海交通大学医学院附属瑞金医院肾内科,上海 200025
    2.上海市徐汇区中心医院医务二科,上海 200031

收稿日期: 2021-11-17

  网络出版日期: 2023-04-23

基金资助

上海市徐汇区中心医院项目(2017XHYY-24)

Study on nutritional risk screening in elderly post-stroke patients

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  • 1. Department of Nephro-logy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Medical Second Division, Shanghai Xuhui District Central Hospital, Shanghai 200031, China

Received date: 2021-11-17

  Online published: 2023-04-23

摘要

目的:探讨老年脑卒中患者中营养风险发生率及营养筛查意义。方法:选取2019年7月至2020年6月上海市徐汇区中心医院康复科收治的490例老年(>60岁)脑卒中患者,患者病程均在在6个月内,入院后24 h内用营养风险筛查2002(nutrition risk screening 2002,NRS 2002)评估表进行营养风险评估,调查该群患者营养风险发生率,并将患者分为营养风险组与正常组。所有患者出院前24 h内用Barthel指数评估其出院时日常生活活动能力(activities of daily living,ADL),并分析所有患者入院时的营养风险、血红蛋白、白蛋白、前白蛋白、肌酐水平与出院时ADL间的关系;同时比较营养风险组与正常组间出院时ADL的差异。结果:490例老年脑卒中患者的营养风险发生率为69.18%,所有患者营养风险评分、前白蛋白、肌酐水平与出院时ADL呈显著负相关,即使在医院经过对症治疗,入院营养风险组ADL在出院时依然显著低于正常组[(47.45±22.35)分比(54.10±22.14)分](P<0.05)。结果:老年卒中患者中,营养风险发生率高达69.18%,在院康复老年脑卒中患者存在营养风险评分高者,其出院时ADL较低,提示对于入院时筛查有营养风险的老年患者需采取更积极的措施。

本文引用格式

崔岩, 葛海萍 . 老年脑卒中后患者营养风险筛查研究[J]. 诊断学理论与实践, 2022 , 21(06) : 726 -729 . DOI: 10.16150/j.1671-2870.2022.06.10

Abstract

Objective: To explore the incidence of nutritional risk in elderly stroke patients and the significance of nutritional screening. Methods: A total of 490 elderly stroke patients admitted to the Rehabilitation Department of Xuhui District Central Hospital in Shanghai from July 2019 to June 2020 were enrolled. All the patients were more than 60 years old, with the duration after stroke less than 6 months. Nutrition risk assessment was conducted in the patients within 24 hours after admission using the Nutrition Risk Screening 2002 (NRS 2002) assessment form,and incidence of nutrition risk was investigated. The patients were divided into nutrition risk group and normal group. Barthel index was used to assess the activities of daily living(ADL) of patients within 24 hours before discharge, and correlation of the nutritional risk, hemoglobin, albumin, prealbumin, creatinine levels with ADL at discharge were analyzed. At the same time, the difference in ADL between the nutrition risk group and the normal group at discharge as compared. Results: The incidence of nutritional risk in 490 elderly stroke patients was 69.18%. The nutritional risk score, prealbumin and creatinine levels of the patients were significantly negatively correlated with ADL at discharge. Even given symptomatic treatment in the hospital, patients in the nutrition risk group had a lower ADL than those of the normal group at discharge(P<0.05). Conclusions: Among the elderly stroke patients, the incidence of nutritional risk is as high as 69.18%. Patients with higher nutritional risk scores in hospital rehabilitation may have lower ADL scores at discharge, indicating that more active measures should be taken to deal with elderly patients having nutritional risk at admission.

参考文献

[1] 朱海英, 李芳, 吴颖, 等. 营养支持在脑卒中治疗中的重要性[J]. 中国医师进修杂志, 2009, 32(1):64-66.
[1] Zhu H Y, Li F, Wu Y, et al. The importance of nutritional support in the treatment of stroke[J]. Chin J Postgrad Med, 2009, 32(1):64-66.
[2] Kim S, Byeon Y. Comparison of nutritional status indicators according to feeding methods in patients with acute stroke[J]. Nutr Neurosci, 2014, 17(3):138-144.
[3] Hutchinson E, Wilson N. Acute stroke, dysphagia and nutritional support[J]. Br J Community Nurs,2013 May;Suppl:S26-S29.
[4] 刘莉莉, 王焱, 夏艳丽. 卒中患者NRS2002营养风险筛查和营养检查指标的相关性[J]. 医学理论与实践, 2018, 31(21):3270-3272.
[4] Liu L L, Wang Y, Xia Y L. Correlation between NRS2002 nutritional risk screening and nutritional testing indicators in stroke patients[J]. J Med Theor &Prac, 2018, 31(21):3270-3272.
[5] 陈禹, 李晓雯, 杨勤兵, 等. 老年脑卒中患者营养状况的评定与影响因素分析[J]. 中国食物与营养, 2014, 20(1):82-85.
[5] Chen Y, Li X W, Yang Q B, et al. Evaluation of nutritional status and analysis of influencing factors in geriatric stroke patients[J]. Food Nutr China, 2014, 20(1):82-85.
[6] 刘艳. 老年脑血管住院患者营养风险筛查的临床研究. 饮食保健, 2015, 2(16):26-27.
[6] Liu Y. Nutritional risk screening in elderly cerebrovascular disease patients. Dietary and health care, 2015, 2(16):26-27.
[7] 刘艳瑰, 黄英. 脑卒中恢复期患者营养风险筛查及营养评估[J]. 中国医药科学, 2021, 11(08):163-165,182.
[7] Liu Y G, Huang Y. Nutritional risk screning and nutritional evaluation for patients recovering from stroke[J]. China Medicine and Pharmacy. 2021, 11(08):163-165,182.
[8] 蔡憐环, 陈辉, 陈盼, 等. 营养风险对脑卒中患者偏瘫肢体功能的影响. 中国中医药现代远程教育, 2017, 15(3):106-108.
[8] Cai L H, Chen H, Chen P, et al. Effect of Nutritional Risk on Hemiplegic Limb Function in Stroke Patients. Chinese Medicine Modern Distance Education of China, 2017, 15(3):106-108.
[9] 于康, 蒋朱明, 毛一雷, 等. 中华人民共和国卫生行业标准(WS/T 427-2013): 临床营养风险筛查. 北京: 中华人民共和国国家卫生和计划生育委员会.2013.
[9] Yu K, Jiang Z M, Mao Y L, et al. Health Industry Standard of the People′s Republic of China(WS/T 427-2013): Nurtritional risk screening Nurtritional risk screening. Beijing:National Health and Birth Control Commission of the People′s Republic of China.2013.
[10] 姚韦羽, 宋雅梅, 井坤娟. 老年脑卒中患者营养不良的研究进展[J]. 医学研究与教育, 2017, 34(6):60-66.
[10] Yan W Y, Song Y M, Jing K J. Advances on malnutrition in the elderly patients with stroke[J]. Med Res Edu, 2017, 34(6):60-66.
[11] 田惠杰, 唐丽梅, 王娟, 等. 老年卒中患者营养风险筛查及相关因素分析[J]. 中华现代护理杂志, 2020, 26(33):4678-4681.
[11] Tian H J, Tang L M, Wang J, et al. Nutritional risk screening and related factors in elderly stroke patients[J]. Chin J Mod Nurs, 2020, 26(33):4678-4681.
[12] 朱海英, 李芳, 吴颖, 等. 营养支持在脑卒中治疗中的重要性. 中国医师进修杂志, 2009, 32(1):64-66.
[12] Zhu H Y, Li F, Wu Y, et al. The importance of nutritional support in the treatment of stroke. Chin J Postgrad Med, 2009, 32(1):64-66.
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