本文選題：老年共病 + 營(yíng)養(yǎng)風(fēng)險(xiǎn)��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:對(duì)某三甲醫(yī)院住院患者的營(yíng)養(yǎng)狀況及老年共病進(jìn)行調(diào)查分析,探討營(yíng)養(yǎng)干預(yù)對(duì)老年共病的影響,為老年共病的營(yíng)養(yǎng)干預(yù)治療提供依據(jù)。方法:1.選取于2014年8月1日至2015年9月30日在某三甲醫(yī)院住院的老年患者為研究對(duì)象,分析老年患者的疾病狀況及營(yíng)養(yǎng)風(fēng)險(xiǎn)。2.對(duì)老年共病患者按NRS2002評(píng)分分為有營(yíng)養(yǎng)風(fēng)險(xiǎn)組與無(wú)營(yíng)養(yǎng)風(fēng)險(xiǎn)組,對(duì)患者人體指標(biāo)、化驗(yàn)指標(biāo)、查爾斯評(píng)分(CCI評(píng)分)、改良老年疾病累計(jì)評(píng)分(MCIRS-G評(píng)分)進(jìn)行統(tǒng)計(jì)分析,分析老年共病患者與營(yíng)養(yǎng)風(fēng)險(xiǎn)的相關(guān)性。3.對(duì)存在營(yíng)養(yǎng)風(fēng)險(xiǎn)的老年共病組患者進(jìn)行為期2周的腸內(nèi)營(yíng)養(yǎng)干預(yù),評(píng)價(jià)營(yíng)養(yǎng)干預(yù)對(duì)老年共病的影響。結(jié)果:1.住院患者老年共病組患者營(yíng)養(yǎng)風(fēng)險(xiǎn)發(fā)生率高于單一疾病組患者(P0.05)。2.人體指標(biāo)比較:兩組患者在年齡、體重指數(shù)、手握力、上臂圍有統(tǒng)計(jì)學(xué)差異(P0.05),在身高、體重等項(xiàng)目上沒有差異統(tǒng)計(jì)學(xué)意義(P0.05)。3.生化指標(biāo)的比較結(jié)果顯示:兩組患者在白蛋白、前白蛋白等方面差異有統(tǒng)計(jì)學(xué)意義(P0.05),其余指標(biāo)未見明顯差異(P0.05)。4.NRS2002營(yíng)養(yǎng)風(fēng)險(xiǎn)評(píng)分比較:兩組患者營(yíng)養(yǎng)風(fēng)險(xiǎn)評(píng)分存在統(tǒng)計(jì)學(xué)差異(P0.05)5.老年共病患者疾病數(shù)量受手握力、上臂圍、NRS2002評(píng)分共同影響。6.對(duì)老年共病患者按是否發(fā)生營(yíng)養(yǎng)風(fēng)險(xiǎn)分組,兩組患者疾病分布有明顯差異(P0.05)。7.改良老年累計(jì)評(píng)分(MCIRS-G評(píng)分)是老年共病患者營(yíng)養(yǎng)風(fēng)險(xiǎn)的危險(xiǎn)因素。8.對(duì)存在營(yíng)養(yǎng)風(fēng)險(xiǎn)的老年共病患者行腸內(nèi)營(yíng)養(yǎng)干預(yù),通過(guò)對(duì)患者治療前后的人體指標(biāo)、生化指標(biāo)進(jìn)行比較,改良老年疾病累計(jì)評(píng)分越低的患者干預(yù)前后存在統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:1.老年共病組的年齡、NRS2002評(píng)分低于老年單一疾病組患者,而老年共病組的BMI、手握力、上臂圍、白蛋白、前白蛋白均低于單一疾病組。2.老年患者營(yíng)養(yǎng)狀況與共病狀態(tài)有顯著相關(guān)性。3.改良老年疾病累計(jì)評(píng)分法是患者發(fā)生營(yíng)養(yǎng)風(fēng)險(xiǎn)的獨(dú)立影響因素。4.老年共病狀況影響營(yíng)養(yǎng)干預(yù)的療效。
[Abstract]:Objective: to investigate and analyze the nutritional status of hospitalized patients in a third Class A Hospital and to explore the effect of nutritional intervention on senile comorbid disease, so as to provide basis for nutritional intervention treatment of senile comorbid disease. Method 1: 1. From August 1, 2014 to September 30, 2015, elderly patients hospitalized in a third Class A Hospital were selected as the research objects. The disease status and nutritional risk of the elderly patients were analyzed. According to the NRS2002 score, the elderly comorbidity patients were divided into nutritional risk group and non-nutritional risk group. The patients' human body index, laboratory test index, Charles score and MCIRS-G score were statistically analyzed. Analysis of the relationship between the elderly patients with comorbid disease and nutritional risk. 3. 3. Two weeks of enteral nutrition intervention was performed to evaluate the effects of nutritional intervention on elderly patients with comorbid diseases. The result is 1: 1. The incidence of nutritional risk in inpatients with coexisting diseases was higher than that in patients with single disease. Comparison of human body indexes: there were significant differences in age, body mass index, grip strength and upper arm circumference between the two groups (P 0.05), but there was no significant difference in height, weight and other items. The comparison of biochemical indexes showed that there were significant differences in albumin and prealbumin between the two groups, but there was no significant difference in the other indexes. 4. Comparison of nutritional risk scores of NRS2002 between the two groups: there was significant difference in nutritional risk scores between the two groups (P 0.05). The number of diseases in elderly patients with syndromes was affected by the grip strength and the NRS2002 score of upper arm circumference. There was a significant difference in the distribution of diseases between the two groups according to the nutritional risk. Improved elderly cumulative score (MCIRS-G) was the risk factor of nutritional risk in elderly patients with comorbid disease. Enteral nutrition intervention was carried out in the elderly patients with nutritional risk. By comparing the human body indexes and biochemical indexes before and after treatment, the patients with lower cumulative score of improved senile diseases had statistical differences before and after intervention (P 0.05). Conclusion 1. The NRS2002 score of elderly patients with concomitant disease was lower than that of patients with single disease, while BMI, grip strength, upper arm circumference, albumin and prealbumin were lower than those of single disease group. There was a significant correlation between nutritional status and co-disease status in elderly patients. The improved accumulative score method of senile disease is an independent influencing factor of patients' nutritional risk. 4. 4. The condition of senile comorbidity affects the effect of nutritional intervention.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R459.3

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