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饮食干预对有营养风险肝硬化患者的效果观察
Observation of dietary intervention on nutritional risk in patients with liver cirrhosis
文章发布日期:2014年06月26日  来源:  作者:张敏,杭蕾,袁晓洁,等  点击次数:1474次  下载次数:426次

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【摘要】:目的 通过营养风险筛查,早期发现肝硬化患者的营养问题,给予个体化饮食干预,纠正其营养不足的状态,避免或减少与饮食相关并发症的出现。方法 用NRS2002标准对肝硬化患者进行营养风险评估,将2011年10月-2013年10月本院收治的134例肝硬化患者随机分为干预组(66例)和对照组(68例)。记录患者的人体测量指标、NRS2002评分、血液化验结果以及住院时间及半年内的住院次数,并进行比较。正态分布的计量资料采用t检验,非正态分布的计量资料采用Wilcoxon秩和检验,计数资料用卡方检验。结果 对照组患者入院时和一周后身体质量指数(BMI)、肌肉量、骨量、血清总蛋白及白蛋白的差异有统计学意义(P均<0.05);干预组患者入院时和一周后体质量、BMI、体水分率、骨量、血红蛋白、前白蛋白、血清白蛋白及NRS2002的评分的差异有统计学意义(P均<0.05);对照组和干预组患者住院一周后血红蛋白、前白蛋白、NRS2002的评分及半年之内的住院次数的差异有统计学意义(P均<0.05)。结论 个体化饮食干预既有近期效果也有远期效果,有营养风险的肝硬化患者需要个体化的饮食干预。
【Abstract】:Objective To detect nutritional problems in liver cirrhosis patients early through nutritional risk screening, and to provide them with individual dietary intervention for improving their malnutrition and avoiding or reducing diet-related complications. Methods The nutritional risk of liver cirrhosis patients was assessed according to the NRS 2002 standard. A total of 134 patients admitted to our hospital from October 2011 to October 2013 were randomly assigned to intervention group (66 cases) and control group (68 cases). Their anthropometric parameters, NRS 2002 scores, blood test results, length of hospital stay, and times of hospitalization within six months were recorded and analyzed. A Student′s t-test was used to analyze continuous data in normal distribution, and the rank sum test for continuous data in non-normal distribution; the chi-square test was used to analyze categorical data. Results Patients in control group showed significant changes in body mass index (BMI), lean muscle mass, bone mass, serum total protein, and albumin one week after admission (P<0.05 for all). Patients in intervention group showed significant changes in body mass, BMI, body moisture rate, bone mass, hemoglobin, prealbumin, serum albumin, and NRS 2002 score one week after admission (P<0.05 for all). There were significant differences between the two groups in hemoglobin, prealbumin, and NRS 2002 score one week after admission and times of hospitalization within six months (P<0.05 for all). Conclusions Individual dietary intervention has both short-term effect and long-term effect. Liver cirrhosis patients with nutritional risk need individual dietary intervention.
【关键字】:肝硬化;营养不良;饮食习惯
【Key words】:liver cirrhosis; malnutrition; food habits
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