目的 调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况,为区域干预提供依据。方法 将江西省南昌市东湖区划分为东、南、西、北、中5个片区,每个片区随机抽取一个街道(管理处),于每年5月份随机抽取各街道(管理处)20名孕妇,每年共抽取100名孕妇,3年共计300名孕妇,采集其尿液样本和家中食用盐样本检测碘含量,以统计学方法进行分析。结果 3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg,碘盐覆盖率为98.67%,碘盐合格率为95.33%,3年的食用盐碘含量比较差异有统计学意义(H=38.545,P<0.05)。孕妇的尿碘水平中位数为115.15 μg/mL,3年来孕妇的尿碘水平中位数均低于150 μg/mL,有62.67%的孕妇碘缺乏,3年间的尿碘水平比较差异有统计学意义(H=9.392,P<0.05),其中2024年的尿碘水平中位数为140.00 μg/mL,校正后高于2022年(Z=2.693,P<0.0167)和2023年(Z=2.590,P<0.0167)。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性(均P>0.05),孕妇碘营养状况与盐碘含量及碘盐质量均无相关性(均P>0.05),孕妇尿碘水平与碘营养状况正相关(rs=0.857,P<0.05),盐碘含量与碘盐质量正相关(rs=0.314,P<0.05)。结论 江西省南昌市东湖区2024年孕妇碘缺乏有所改善,但整体形势严峻,超半数的孕妇碘缺乏,食用碘盐基本符合国家消除碘缺乏病标准,但仍需改进。卫生部门要强化孕妇碘营养监测,向孕妇科普碘缺乏病知识,增强补碘意识,促其科学补碘。盐业监管部门需加大监管,严控碘盐质量,确保东湖区居民食盐合格。
Objective To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District,Nanchang City,Jiangxi Province from 2022 to 2024,and provide a basis for regional intervention.Methods Donghu District was divided into five areas:East,South,West,North,and Central.A street(management office)was randomly selected from each area,and 20 pregnant women were randomly selected from each street(management office)in May each year.A total of 100 pregnant women were selected each year,for a total of 300 pregnant women over three years.Urine samples and household salt samples were collected to detect iodine content,and statistical analysis was conducted.Results Over the past three years,the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg,the iodized salt coverage rate was 98.67%,and the iodized salt qualification rate was 95.33%.There were differences in the iodine content of cooking salt in the three years(H=38.545,P<0.05).The median urinary iodine level of pregnant women was 115.15 μg/mL.In the past three years,the median urinary iodine levels of pregnant women were all lower than 150 μg/ml,and 62.67% of pregnant women were iodine-deficient.There were differences in the urinary iodine levels in the three years(H=9.392,P<0.05).Among them,the median urinary iodine level in 2024 was 140.00 μg/mL,which was significantly higher than that in 2022(Z=2.693,P<0.0167)and 2023(Z=2.590,P<0.0167)after correcting the significance level.Spearman correlation analysis results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt(all P>0.05),and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt(all P>0.05).The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status(rs=0.857,P<0.05),and the iodine content in salt is positively correlated with the quality of iodized salt(rs=0.314,P<0.05).Conclusions In 2024,the iodine deficiency among pregnant women in Donghu District,Nanchang City,Jiangxi Province was improved,but the overall situation is still severe.More than half of pregnant women were iodine-deficient.The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders,but still needed to be improved.The health department should strengthen the monitoring of iodine nutrition among pregnant women,popularize knowledge about iodine deficiency disorders to pregnant women,enhance their awareness of iodine supplementation,and promote their scientific iodine supplementation.The salt industry supervision department needs to strengthen supervision,strictly control the quality of iodized salt,and ensure that the cooking salt of residents in Donghu District is qualified.
目的 探讨降钙素原(PCT)联合营养指标对肝硬化营养状况的评定价值。方法 选取2021年2月—2022年3月在右江民族医学院附属医院感染科住院的140例肝硬化患者,根据营养风险筛查2002(NRS 2002)将其分为有营养风险组和无营养风险组。比较两组肝硬化患者中营养指标体质指数(BMI)、血红蛋白(HGB)、前白蛋白(PA)、白蛋白(ALB)、视黄醇结合蛋白(RBP)水平, 并分析它们与PCT的相关性。结果 BMI、HGB、ALB、PA及RBP水平低于低营养风险组(P<0.05); 营养指标(BMI、HGB、ALB、PA、RBP)与PCT呈负相关(P<0.05)。二元Logistics回归分析发现ALB、PCT是肝硬化患者营养风险的危险因素(P<0.05)。ROC结果显示PCT与ALB的联合营养指标评定肝硬化营养不良的曲线下面积为0.984,(95%CI:0.964~1.000), 灵敏度98.8%, 特异度93.3%, 约登指数0.921; ALB、PCT的AUC分别为0.919、0.974。结论 肝硬化患者PCT水平与其营养状况密切相关, 对营养状况的评定有一定的价值, 联合评定能有效提高其评定价值。
Objective To explore the value of procalcitonin(PCT)combined with nutritional indexes in evaluating the nutritional status of liver cirrhosis.Methods A total of 140 patients with cirrhosis admitted to the Department of Infection of the Affiliated Hospital of Youjiang Medical College for Nationalities from February 2021 to March 2022, they were selected and divided into with and without nutritional risk group according to nutritional risk screening 2002(NRS 2002).The levels of body mass index(BMI), hemoglobin(HGB), prealbumin(PA), albumin(ALB)and retinol binding protein(RBP)in two groups of patients with cirrhosis were compared, and the correlation between them and PCT was analyzed.Results The levels of BMI, HGB, ALB, PA and RBP were lower than those of low nutritional risk group(P<0.05).The nutritional indices(BMI, HGB, ALB, PA, RBP)were negatively correlated with PCT(P<0.05).Binary Logistics regression analysis showed that ALB and PCT were risk factors affecting nutritional risk in patients with cirrhosis(P<0.05).ROC results showed that the area under the curve was 0.984(95% confidence interval:0.964 ~ 1.000), sensitivity 98.8%, specificity 93.3%, and Yoden index 0.921 for the combined PCT and ALB indexes predicting malnutrition in cirrhosis.The AUC of ALB and PCT were 0.919 and 0.974, respectively.Conclusions The level of PCT in patients with cirrhosis is closely related to their nutritional status, which has certain value in the evaluation of nutritional status, and combined prediction can effectively improve the evaluation value.
目的 分析超早期阶梯式协同营养管理在改善重症急性胰腺炎患者喂养中的应用效果。方法 抽取2020年1月—2022年1月南阳市中心医院收治的80例重症急性胰腺炎患者为研究对象,随机数字表法分为观察组和参照组,各40例,两组患者均给予常规营养干预措施,其中观察组患者在以上基础上给予超早期阶梯式协同营养管理,对比两组患者的临床症状消退时间、营养状况、喂养相关并发症、喂养不耐受发生率。结果 与参照组相比,观察组患者的临床症状消退时间更短(P<0.05),观察组患者的体质量指数、上臂肌围、肱三头肌皮褶厚度及血清清蛋白水平更高(P<0.05);两组患者的喂养相关并发症主要包括恶心呕吐、误吸、腹泻、感染,观察组患者的喂养相关并发症发生率为7.50%,参照组患者的喂养相关并发症发生率为25.00%,观察组患者的喂养相关并发症发生率低于参照组(P<0.05);观察组患者喂养不耐受发生2例(5.00%),参照组患者喂养不耐受发生9例(22.50%),观察组患者喂养不耐受发生率低于参照组(P<0.05)。结论 重症急性胰腺炎患者实施超早期阶梯式协同营养管理可降低喂养不耐受发生率及喂养相关并发症发生率,改善患者营养水平。
Objective To analyze the application effect of ultra early stepped collaborative nutrition management on improving feeding in patients with severe acute pancreatitis.Methods Eighty patients with severe acute pancreatitis admitted to our hospital from January 2020 to January 2022 were selected as research subjects and randomly divided into observation group and reference group,with 40 cases in each group.Patients in both groups were given conventional nutritional intervention measures,among which patients in the observation group were given super-early stepped collaborative nutritional management on the basis of the above.Clinical symptom resolution time,nutritional status,feeding related complications and feeding intolerance rate were compared between the two groups.Results Compared with the reference group,the time of clinical symptoms resolution in the observation group was shorter(P<0.05),and the body mass index,upper arm muscle circumference,triceps skin fold thickness and serum albumin level in the observation group were higher(P<0.05).The feeding-related complications of the two groups mainly included nausea and vomiting,aspiration,diarrhea and infection.The incidence of feeding-related complications in the observation group was 7.50%,and that in the reference group was 25.00%.The incidence of feeding-related complications in the observation group was lower(P<0.05).There were 2 cases of feeding intolerance in the observation group,the feeding intolerance rate was 5.00%,and 9 cases of feeding intolerance in the reference group,the feeding intolerance rate was 22.50%,the feeding intolerance rate in the observation group was lower(P<0.05).Conclusions Implementing ultra early stepped collaborative nutritional management in patients with severe acute pancreatitis can reduce the incidence of feeding intolerance and feeding related complications,and improve nutritional levels.
目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表(MoCA)评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高(P<0.05);住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少(P<0.05);护理后,联合组MoCA评分高于对照组(P<0.05)。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。
Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children.Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected.They were divided into two groups according to the nursing method,with 58 cases in each group.The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention.The satisfaction,the compliance rate and MoCA score were compared between two groups.Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group(P<0.05).Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group(P<0.05).After nursing,the MoCA score of the combined group was higher than that of the control group(P<0.05).Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction.
肝癌患者因食欲降低、进食减少导致不同程度的营养不良,引发厌食症,甚至恶病质,严重影响患者生存质量。食欲评估是降低营养风险的基础,医护人员可通过食欲症状的评估调整患者饮食及营养指导措施,以改善患者营养状态,提高生存质量。该文对食欲的评估工具、方法及干预在肝癌营养不良患者中的应用现状进行阐述,为肝癌患者的食欲干预提供科学依据。
Hepatocellular carcinoma patients suffer from different degrees of malnutrition due to decreased appetite and eating,which triggers anorexia and even cachexia,seriously affecting the quality of patient survival.Appetite assessment is the basis for reducing nutritional risk,and healthcare professionals can adjust patients’ diet and nutritional guidance measures through the assessment of appetite symptoms in order to improve patients’ nutritional status and survival quality.In this paper,the current status of the assessment tools,methods and interventions of appetite in malnutrition patients with hepatocellular carcinoma are described to provide a scientific basis for appetite interventions.
目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[(55.41±19.63)h vs (81.46±19.39) h],前白蛋白水平高于对照组[(241.14±65.73)g/L vs(217.35±51.63)g/L],组间比较差异有统计学意义(P<0.05)。血清总蛋白水平[(70.55±18.89)g/L vs (68.16±20.05)g/L]、血清白蛋白水平[(53.22±17.76)g/L vs(50.76±18.54)g/L]、淋巴细胞计数[(1.60±0.54)×109/L vs (1.56±0.55)×109/L]以及肛门排便时间[(89.67±22.31)h vs (97.77±21.27)h ]在组间比较差异无统计学意义(P>0.05)。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。
Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery.Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022.Patients were randomly allocated into either the observational or control group,with 50 patients in each group.The randomization was performed using a random number table.The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days.The control group received standard postoperative care.Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups.Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group(55.41±19.63 h vs 81.46±19.39 h,P<0.05),as well as higher prealbumin levels(241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05).However,there were no significant differences between the two groups in terms of serum total protein levels(70.55±18.89 g/L vs 68.16±20.05 g/L),serum albumin levels(53.22±17.76 g/L vs 50.76±18.54 g/L),lymphocyte counts[(1.60±0.54)×109/L vs (1.56±0.55)×109/L],and time to the first defecation from the anus(89.67±22.31 h vs 97.77±21.27 h)(all P>0.05).Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery.It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status.
目的 构建并验证机械通气患儿肠内营养支持发生误吸的风险预测模型。方法 回顾性分析中山市博爱医院2021年3月—2023年3月儿童重症监护病房330例行机械通气并进行肠内营养的患儿临床资料,通过二元Logistic回归,获取机械通气患儿肠内营养支持发生误吸的预测因素,绘制列线图模型,并进行模型评价及验证。结果 330例机械通气患儿中,104例患儿发生误吸、226例未发生误吸。两组患儿在意识状态、机械通气方式、管饲量、胃残留量、胃管置入深度、促胃动力药、镇静剂等方面对比差异具有统计学意义(P<0.05)。二元Logistic结果显示,胃残留量、机械通气方式、管饲量、意识状态、胃管置入深度、促胃动力药、镇静剂是机械通气患儿肠内营养支持发生误吸的影响因素(P<0.05)。建模组AUC为0.810(95%CI:0.760~0.860),Hosmer-Lemesh结果显示,χ2=3.245,P=0.846;外部验证组AUC为0.873(95%CI:0.831~0.914),Hosmer-Lemesh结果显示,χ2=3.567,P=0.875。建模组和训练组DCA曲线大部分落于Y=0上方。建模组与外部验证组校准曲线均与参考曲线高度贴合,预测概率与实际概率接近,校准度良好。结论 基于胃残留量、机械通气方式、管饲量、意识状态、胃管置入深度、促胃动力药、镇静剂等7项指标构建的风险预测模型具有一定的临床价值,可作为医护人员识别肠内营养机械通气误吸高危患儿的工具。
Objective To establish and verify the risk prediction model of enteral nutritional aspiration in children with mechanical ventilation.Methods The clinical data of 330 children who underwent mechanical ventilation and enteral nutrition in the PICU of Zhongshan Boai Hospital from March 2021 to March 2023 were retrospectively analyzed.The independent predictive factors of enteral nutrition support aspiration in children with mechanical ventilation were obtained by binary Logistic regression,and the nomographic model was drawn,and the model was evaluated and verified. Results Among 330 children with mechanical ventilation,104 had aspiration and 226 did not.There were statistically significant differences between the two groups in consciousness state,mechanical ventilation mode,tube feeding amount,gastric residual amount,gastric tube insertion depth,gastric motivity drugs,sedatives,etc.(P<0.05).Binary Logistic results showed that gastric residual amount,mechanical ventilation mode,tube feeding amount,state of consciousness,depth of gastric tube insertion,gastric motonics and sedatives were the influential factors of enteral nutritional aspiration in children with mechanical ventilation(P<0.05).The AUC of the modeling group was 0.810(95%CI:0.760-0.860),and the Hosmer-Lemesh result showed that χ2=3.245,P=0.846.The AUC of the external verification group was 0.873(95%CI:0.831-0.914),and the Hosmer-Lemesh result showed that χ2=3.567,P=0.875.The DCA curves of modeling group and training group mostly were above Y=0.The calibration curves of the modeling group and the external verification group are highly fit to the reference curves,and the prediction probability was close to the actual probability,and the calibration degree was good.Conclusion sThe risk prediction model based on 7 indexes,including stomach residual amount,mechanical ventilation mode,tube feeding amount,state of consciousness,depth of gastric tube insertion,gastric motivity drug and sedative,with certain clinical value,and can be used as a tool for medical staff to identify children at high risk of enteral nutritional mechanical aspiration.
目的 探讨超声监测导向下早期肠内营养(EEN)在重症脓毒血症(SS)有创通气(IV)患者中的应用效果。方法 选取2021年2月—2023年11月连州市人民医院收入的115例SS-IV患者,依据随机数字表法分为对照组(n=57)、超声监测组(n=58)。所有患者均予重症监护病房(ICU)综合治疗,在此基础上对照组实施临床经验的传统肠内营养(EN)干预,超声监测组实施超声监测导向下EEN干预,均监测至治疗结束。统计两组IV时间、ICU停留时间、EN达标时间、EN不耐受发生率、相关并发症发生率,比较干预前、EN结束时营养状况[白蛋白(ALB)、总蛋白(TP)、前白蛋白(PA)]、序贯器官衰竭评分(SOFA)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。结果 对照组剔除放弃治疗1例,死亡2例,纳入54例;超声监测组剔除放弃治疗1例,死亡1例,纳入56例。超声监测组EN达标时间[(40.18±8.46)h]、IV时间[(7.12±1.44)d]、ICU停留时间[(9.21±1.63)d]短于对照组[(46.03±10.15)h、(8.02±1.62)d、(10.18±1.54)d](t=3.288、3.082、3.206,均P<0.05)。EN结束时超声监测组SS-IV患者血清ALB[(32.05±3.13)g/L]、TP[(65.36±3.62)g/L]、PA[(0.24±0.06)g/L]高于对照组[(30.28±2.24)g/L、(63.28±4.24)g/L、(0.21±0.05)g/L](t=3.400、2.770、2.843,均P<0.05)。EN结束时超声监测组APACHEⅡ评分[(15.85±1.93)分]、SOFA评分[(7.42±1.64)分]低于对照组[(17.02±2.04)分、(8.35±2.03)分](t=3.091、2.648,均P<0.05)。超声监测组EN不耐受发生率[12.50%(7/56)]低于对照组[29.63%(16/54)],超声监测组相关并发症发生率[8.93%(5/56)]低于对照组[24.07%(13/54)](χ2=4.878、4.608,均P<0.05)。结论 超声监测导向下EEN干预应用于SS-IV患者,可改善患者病情与营养状况,降低EN不耐受及相关并发症发生风险,缩短恢复时间。
Objective To investigate the effect of ultrasound monitoring guided early enteral nutrition(EEN)in patients with severe sepsis(SS)and invasive mechanical ventilation(IV).Methods A total of 115 SS-IV patients admitted to Lianzhou People's Hospital from February 2021 to November 2023 were randomly divided into control group(n=57)and ultrasound monitoring group(n=58).All patients were given comprehensive treatment in intensive care unit(ICU).On this basis,traditional enteral nutrition(EN)intervention with clinical experience was implemented in control group,and EEN intervention guided by ultrasonic monitoring was implemented in ultrasound monitoring group.All patients were monitored until the end of treatment.IV time,ICU stay time,EN compliance time,incidence of EN intolerance,and incidence of related complications were analyzed in the 2 groups.Nutritional status [albumin(ALB),total protein(TP),prealbumin(PA)],sequential organ failure assessment(SOFA),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)were compared before intervention and at the end of EN.Results In control group,1 cases gave up,2 cases died,and 54 cases were included.In ultrasound monitoring group,1 case gave up,1 case died,and 56 cases were included.The EN compliance time [(40.18±8.46)h],IV time [(7.12±1.44)d] and ICU stay time [(9.21±1.63)d] of ultrasound monitoring group were shorter than those of control group [(46.03±10.15)h,(8.02±1.62)d,(10.18±1.54)d](t=3.288,3.082,3.206,all P<0.05).At the end of EN,serum ALB[(32.05±3.13)g/L],TP[(65.36±3.62)g/L],PA[(0.24±0.06)g/L] of SS-IV patients in ultrasound monitoring group were higher than those in control group [(30.28±2.24)g/L,(63.28±4.24)g/L,(0.21±0.05)g/L](t=3.400,2.770,2.843,all P<0.05).At the end of EN,APACHEⅡ scores [(15.85±1.93)points] and SOFA scores [(7.42±1.64)points] of ultrasound monitoring group were lower than those of control group [(17.02±2.04)points and(8.35±2.03)points](t=3.091,2.648,all P<0.05).The incidence of EN intolerance in ultrasound monitoring group [12.50%(7/56)] was lower than that in control group [29.63%(16/54)],and the incidence of related complications in ultrasound monitoring group [8.93%(5/56)] was lower than that in control group [24.07%(13/54)](χ2=4.878,4.608,all P<0.05).Conclusions EEN intervention guided by ultrasonic monitoring in SS-IV patients can improve the nutritional status of patients,reduce the risk of EN intolerance and related complications,shorten the recovery time,and reduce the progression of patients' disease.
目的 探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法 回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况(CONUT)评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果 共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组(P=0.005 3),且2组性别构成存在差异,男性患者多于女性(P=0.037 0)。CONUT评分>2.5组患者的肿瘤直径较大(P=0.039 4)。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组(P=0.008 3)。单因素Logistic回归分析,年龄(OR=1.127;95%CI:1.028~1.236;P=0.011)、CONUT评分(OR=0.339;95%CI:0.151~0.764;P=0.009)是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄(OR=1.115;95%CI:1.008~1.233;P=0.035)、CONUT评分(OR=0.414;95%CI:0.175~0.982;P=0.045)是患者发生短期并发症的危险因素。结论 CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。
Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer.Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed.Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status(CONUT)score was calculated.The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated.Results A total of 223 patients were included in this study.The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter.The average age of the group with CONUT score > 2.5 was significantly higher than that of the group with CONUT score < 2.5(P=0.005 3).Moreover,there was significant difference between the sex ratio of the two groups,with male more than female(P=0.037 0).The tumor diameter was significantly larger in the group with CONUT score > 2.5(P=0.039 4).In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score > 2.5 than in the group with CONUT score < 2.5(P=0.008 3).Univariate logistic regression analysis showed that age(OR=1.127;95% CI:1.028-1.236;P=0.011)and CONUT score(OR=0.339;95% CI:0.151-0.764;P=0.009)were the risk factors for short-term complications.Multivariate logistic regression analysis showed that age(OR=1.115;95% CI:1.008-1.233;P=0.035)and CONUT score(OR=0.414;95% CI:0.175-0.982;P=0.045)were the risk factors for short-term complications.Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications.
目的 探讨个体化肠内营养联合电动起立床训练对老年脑卒中卧床患者器官功能的影响。方法 严格执行纳排标准后前瞻性选取2021年7月—2022年9月期间我院收治的97例老年脑卒中卧床患者作为研究对象,按照随机数字表法分为单一组48例给予脑卒中基础干预,联合组49例给予个体化肠内营养联合电动起立床训练干预,观察2组患者营养状况、肺功能指标以及心功能指标。结果 干预4周后,2组血清前蛋白、血清白蛋白、血红蛋白水平均上升且联合组高于单一组(P<0.05);2组用力肺活量(FVC)、第1秒用力呼吸容积(FEV1)、FEV1/FVC均上升且联合组高于单一组(P<0.05);联合组左心室收缩期内径、左室舒张末期内径低于单一组,联合组左心室射血分数高于单一组(P<0.05)。结论 个体化肠内营养联合电动起立床训练干预可有效改善老年脑卒中卧床患者营养状况及心肺功能,促进其机体功能的恢复。