本文選題：營養(yǎng)不良 + 微量營養(yǎng)評價(jià)��； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究目的本次研究的主要目的是通過橫斷面研究調(diào)查廣州市某三級甲等醫(yī)院老年住院患者的營養(yǎng)狀況,旨在研究廣州市老年住院患者的營養(yǎng)狀態(tài),并探尋其相關(guān)影響因素,從而為醫(yī)院醫(yī)療護(hù)理針對性的采取干預(yù)措施提供科學(xué)依據(jù),提高老人健康水平。同時(shí)使老年人掌握營養(yǎng)知識,加強(qiáng)自身營養(yǎng)保健,改進(jìn)老年人營養(yǎng)與健康狀況,提高他們的生活質(zhì)量,實(shí)現(xiàn)健康老齡化。研究方法本研究采用橫斷面調(diào)查方法,調(diào)查2016年1月-2016年7月期間在廣州市某三級甲等醫(yī)院的所有符合納入、排除標(biāo)準(zhǔn)的60歲以上老年住院患者。主要應(yīng)用結(jié)構(gòu)化問卷收集研究對象的一般情況;生活習(xí)慣及健康狀況;抑郁程度情況;日常活動能力(Activity of Daily Living,ADL)情況以及老年住院患者的營養(yǎng)狀況,并通過體格測量和實(shí)驗(yàn)室檢查獲得人體測量學(xué)和血生化指標(biāo)相關(guān)信息。原始數(shù)據(jù)使用SPSS 20.0統(tǒng)計(jì)軟件進(jìn)行錄入、整理和分析。數(shù)據(jù)的整理分析使用頻數(shù)、構(gòu)成比、均數(shù)和標(biāo)準(zhǔn)差對調(diào)查結(jié)果進(jìn)行統(tǒng)計(jì)描述。計(jì)數(shù)資料用構(gòu)成比表示;對連續(xù)性變量進(jìn)行正態(tài)性檢驗(yàn)和方差齊性檢驗(yàn),服從正態(tài)分布的采用獨(dú)立樣本檢驗(yàn)和方差分析,如不符合則采用Mann Whitney U檢驗(yàn)和Kruskal-Wallis H檢驗(yàn);計(jì)數(shù)資料采用卡方檢驗(yàn)。影響因素分析先用單因素檢驗(yàn)篩選對營養(yǎng)狀況影響有統(tǒng)計(jì)學(xué)意義的變量,再納入多元逐步回歸,用Ordial Logistic回歸分析和多元回歸分析。研究結(jié)果1、本研究調(diào)查了廣州市某三級甲等醫(yī)院的365名老年住院患者,其中男性215例(占比58.90%),女性150例(占比41.10%)。2、慢性病患病率高,本次研究中有97.53%的老年住院患者患有慢性病,其中18.36%的老年住院患者患一種慢性病,48.77%的老年住院患者患2-3種慢性病,30.41%的老年住院患者患≥4種慢性病;調(diào)查人群中高血壓患病率為58.08%,糖尿病的患病率為50.14%。3、抑郁程度得分平均值為3.65,365名老年住院患者中,88人患有輕度抑郁,約占24.11%;23人患有重度抑郁者,約占6.30%。4、Barthel指數(shù)計(jì)分平均分是56.39±11.78。365名老年住院患者中,評為良(得分60分)的患者為87人(23.8%),評為中等(得分60～41分)的患者為198人(54.25%),評為差(得分≤40分)的患者為80人(23.8%)。5、隨著年齡的增加,體重和BMI、白蛋白(ABL)呈現(xiàn)出下降趨勢,而體脂肪百分百隨著年齡的增加呈現(xiàn)上升趨勢;隨著老年住院患者BMI的增加,其體重、體脂含量、腰圍、臀圍、腰臀比、體脂肪百分比、血紅蛋白、白蛋白、總膽固醇、甘油三酯、和低密度脂蛋白膽固醇的均值也隨之升高,高密度脂蛋白膽固醇的均值隨BMI的增加而降低。6、微型營養(yǎng)評價(jià)法(Mini Nutritional Assessment,MNA)結(jié)果顯示,365名老年患者的MNA平均得分為24.87士 4.32,24名(6.6%)患者存在有營養(yǎng)不良,88名(24.1%)患者存在有營養(yǎng)不良風(fēng)險(xiǎn)(1 7≤MNA分值≤23.5),253名(69.3)營養(yǎng)正常(MNA分值≥24)。7、影響老年住院患者人營養(yǎng)狀況的主要因素從大到小依次為:經(jīng)濟(jì)情況、慢性病患病數(shù)量、年齡、日�；顒幽芰�、抑郁程度得分、是否關(guān)注營養(yǎng)知識。其中與慢性病患病數(shù)量、年齡、抑郁程度得分呈負(fù)相關(guān);而與經(jīng)濟(jì)情況、日�；顒幽芰�、是否關(guān)注營養(yǎng)知識呈正相關(guān)。研究結(jié)論1、依據(jù)MNA評分標(biāo)準(zhǔn),365名住院患者中,24名(6.6%)患者存在有營養(yǎng)不良,88名(24.1%)患者存在有營養(yǎng)不良風(fēng)險(xiǎn)(17≤MNA分值≤23-5),253名(69.3)營養(yǎng)正常(MNA分值≥24)。2、影響老年住院患者人營養(yǎng)狀況的主要因素從大到小依次為:經(jīng)濟(jì)情況、慢性病患病數(shù)量、年齡、日�；顒幽芰�、抑郁程度得分、是否關(guān)注營養(yǎng)知識。3、相關(guān)醫(yī)療機(jī)構(gòu)應(yīng)該對住院的老年患者的營養(yǎng)狀況早期篩查和評估,以早期發(fā)現(xiàn)有營養(yǎng)不良風(fēng)險(xiǎn)的人群,并結(jié)合相關(guān)因素,制定具體的切實(shí)可行的三級預(yù)防方案。
[Abstract]:The main purpose of this study is to investigate the nutritional status of the elderly hospitalized patients in a class three grade a hospital in Guangzhou by cross-sectional study. The purpose of this study is to study the nutritional status of the elderly inpatients in Guangzhou, and to explore the related factors, so as to provide scientific basis for the intervention measures of the hospital medical care needles. At the same time, the elderly people have a healthy level of nutrition, strengthen their nutrition and health care, improve the nutritional and health status of the elderly, improve their quality of life, and achieve a healthy aging. The research method used a cross-sectional survey method to investigate all the three grade A hospitals in Guangzhou in the period of July, January 2016, -2016 years. The elderly hospitalized patients over 60 years of age, which were included in the inclusion and exclusion criteria, mainly used a structured questionnaire to collect the general situation of the subjects; the living habits and health status; the degree of depression; the daily activity (Activity of Daily Living, ADL) and the nutritional status of the elderly hospitalized patients; and through physical and laboratory tests. Obtain the related information of anthropometry and blood biochemical indexes. The original data are recorded, arranged and analyzed using SPSS 20 statistical software. The data are arranged and analyzed using frequency, the composition ratio, the mean number and the standard deviation are used to describe the survey results. The counting data is represented by the composition ratio; the continuity variables are normal test and Fang Chaqi. An independent sample test and an analysis of variance were used in the normal distribution. Mann Whitney U test and Kruskal-Wallis H test were used if the non conformity was used; the counting data were checked by chi square test. The factors influencing factors analysis first screened the variables with statistical significance on the nutritional status by single factor test, and then included multiple stepwise regression and Ordia L Logistic regression analysis and multiple regression analysis. Results 1. This study investigated 365 elderly hospitalized patients in a class three grade a hospital in Guangzhou, including 215 men (58.90%), 150 women (41.10%).2, high prevalence of chronic diseases, and 97.53% of the elderly hospitalized patients with chronic diseases, of which 18.36% of the elderly were old. The hospitalized patients had a chronic disease in the year, 48.77% of the elderly inpatients suffered from 2-3 chronic diseases and 30.41% of the elderly hospitalized patients suffered from 4 chronic diseases. The prevalence rate of hypertension in the survey population was 58.08%, the prevalence rate of diabetes was 50.14%.3, the average depression score was 3.65365 in the elderly inpatients and 88 had mild depression, about 24.. 11%; 23 people with severe depression accounted for about 6.30%.4, and the average score of the Barthel index was 56.39 + 11.78.365 in the elderly inpatients, and 87 (23.8%) was rated as good (score 60), and 198 (54.25%) in the middle (score 60~41) patients (54.25%), and the patients with a poor score (score < 40) were 80 (23.8%), with the increase of age. Weight and BMI, albumin (ABL) showed a downward trend, and body fat increased by 100 percent with age; with the increase of BMI in elderly patients, the weight, body fat content, waist circumference, hip circumference, waist hip ratio, body fat percentage, hemoglobin, white egg white, total cholesterol, triglyceride, and low density lipoprotein cholesterol The average value of HDL cholesterol decreased with the increase of BMI and.6. The Mini Nutritional Assessment (MNA) results showed that the average MNA score of 365 elderly patients was 24.87 n 4.32,24 names (6.6%) with malnutrition and 88 (24.1%) patients had a malnutrition risk (17 < < MNA score). < < 23.5), 253 (69.3) nutrition was normal (MNA score > 24).7. The main factors affecting the nutritional status of the elderly inpatients from large to small were economic situation, the number of chronic diseases, age, ability of daily activity, the score of depression, and whether they paid attention to the knowledge of nutrition. Conclusion 1, among 365 hospitalized patients, 24 (6.6%) had malnutrition, 88 (24.1%) had malnutrition (17 < < MNA score < 23-5), 253 (69.3) (69.3) nutrition (MNA score > 24).2, affecting the old, according to the MNA score standard. The main factors of nutritional status of inpatients in inpatients from large to small were economic situation, the number of chronic diseases, age, ability of daily activity, the score of depression,.3, and early screening and evaluation of the nutritional status of elderly patients in hospital, in order to find the risk of malnutrition early. Crowd, and combined with relevant factors, formulate specific and practical three level prevention program.

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R151.41

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