陈格亮, 郑艳, 花超, 温晓丽, 刘璟, 张静. 老年上消化道出血患者的营养状况及营养支持治疗[J]. 上海预防医学, 2015, 27(10): 627-630.
引用本文: 陈格亮, 郑艳, 花超, 温晓丽, 刘璟, 张静. 老年上消化道出血患者的营养状况及营养支持治疗[J]. 上海预防医学, 2015, 27(10): 627-630.
CHEN Ge-liang, ZHENG Yan, HUA Chao, WEN Xiao-li, LIU Jing, ZHANG Jing. Nutrition analysis and support therapy for upper gastrointestinal hemorrhage in elderly patients[J]. Shanghai Journal of Preventive Medicine, 2015, 27(10): 627-630.
Citation: CHEN Ge-liang, ZHENG Yan, HUA Chao, WEN Xiao-li, LIU Jing, ZHANG Jing. Nutrition analysis and support therapy for upper gastrointestinal hemorrhage in elderly patients[J]. Shanghai Journal of Preventive Medicine, 2015, 27(10): 627-630.

老年上消化道出血患者的营养状况及营养支持治疗

Nutrition analysis and support therapy for upper gastrointestinal hemorrhage in elderly patients

  • 摘要: 目的 分析120例老年上消化道出血患者的营养状况,并观察早期给予肠内营养支持治疗对上消化道出血患者预后的作用。方法 患者随机分为早期营养干预组(n=60)和对照组(n=60)。两组患者除营养支持外均采用相同的制酸及保护胃黏膜处理。患者入院后由经过培训的专业人员采用统一的MNA-SF 评估问卷,对患者的营养状况进行评定。早期营养干预组给予基础治疗后,采用鼻饲肠内营养液1000~2000ml/d,一次性输注或间歇滴注给予肠内营养支持治疗,2周后观察结果。结果 120例老年上消化道出血的患者中,营养不良者65例(54.17%),存在营养不良风险者36例(30.00%),正常营养状况者19例(15.83%)。早期营养干预组患者咖啡色呕吐物的发生率为5.00%,明显低于对照组(18.33%)。干预后,早期营养干预组患者的白蛋白、总蛋白、血红蛋白和血小板较干预前明显升高,血钾、凝血时间、活化凝血酶原时间明显降低;而对照组白蛋白、血小板和凝血时间较干预前升高,血钾较干预前降低。干预后,干预组患者血钾、白蛋白、总蛋白、血红蛋白与红细胞比容均明显高于对照组,凝血时间、活化凝血酶原时间均明显低于对照组。结论 早期合理、均衡的肠内营养支持治疗可以明显改善老年上消化道出血患者的营养状况,并对预后有积极的作用。

     

    Abstract: Objective To analyze the nutritional status of 120 elderly patients with upper gastrointestinal hemorrhage, and observe the effect and prognosis of early giving enteral nutrition support therapy for them. Methods Patients were randomly divided into early nutritional intervention group (n=60) and control group (n=60). Except for nutritional support,the patients in two groups received the same treatment for gastric acid inhibition and gastric mucosa protection. The patients were investigated by trained professionals with unified MNA-SF-assessment questionnaire to assess the nutritional status on admission. The early nutritional intervention group was given basic treatment, and then initiated nasogastric enteral nutrition 1 000~2 000 mL/d, one-time infusion or intermittent drip to give enteral nutrition therapy. Results In the 120 cases of upper gastrointestinal hemorrhage, 65 were with malnutrition, the rate being 54.17%, 36 with malnutrition risk, the rate being 30%,and 19 in normal nutritional status, the rate being 15.83%. In early nutritional intervention group, patients had a coffee-like vomitus incidence of 5.00%,which was significantly lower than the incidence of 18.33% in the control group. After the intervention, albumin, total protein, hemoglobin and platelet in early nutritional intervention group was markedly higher than before; serum potassium, clotting time, activated prothrombin time significantly less than before; while albumin, platelet and clotting time in the control group was higher than before, level of potassium was lower than before. After the intervention, potassium, albumin, total protein, hemoglobin and hematocrit in the intervention group was significantly higher than that in the control group, while clotting time and activated LMprothrombin time was significantly lower than that in the control group. Conclusion Early rational and balanced enteral nutrition therapy can significantly improve the nutritional status of elderly patients with upper gastrointestinal hemorrhage, and have a positive effect on the prognosis for the patients.

     

/

返回文章
返回