综合营养护理干预对老年管饲患者营养状况的影响  

Effect of Multiplex Nutritional Nursing Intervention on the Nutrition of Aged Tube-feeding Patients

作　　者：徐永能[1] 卢小萍 黎明[1] 李远红[2] 张月华[1] 黄巧[1] 申铁梅[3] 符霞[4] 

机构地区：[1]广东省人民医院老年医学研究所,广州510080 [2]广东省人民医院营养科 [3]广东省人民医院监护中心 [4]广东省人民医院血透室

出　　处：《解放军护理杂志》2008年第18期4-6,13,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：广东省人民医院科学技术研究基金资助课题(Y200567)

摘　　要：目的探讨综合营养护理干预对改善老年管饲患者营养不良(轻、中度)的效果。方法将120例轻、中度营养不良的老年管饲患者,随机分为对照组和实验组各60例,对照组实施常规护理;实验组除常规护理外,进行综合营养护理干预:(1)对护士进行系统的管饲专科知识、营养知识培训;(2)成立由医生、营养师、护士组成的营养支持小组,制定个性化营养计划;(3)改变置管长度;(4)牢固固定胃管、胃造瘘管;(5)管饲时配合食物彩图和食物模型,充分调动患者的视、听、触觉刺激,从而增加患者的食欲,促进其消化、吸收;(6)患者管饲过程中和管饲后至少30 min内取半坐位;(7)吞咽功能和摄食训练;(8)出院指导和上门随访。综合营养护理干预时间为1个月。结果干预前实验组与对照组营养状况主观评价差异无统计学意义,干预后实验组明显优于对照组(P<0.05);干预前实验组与对照组总白蛋白、白蛋白、转铁蛋白、前白蛋白的差异无统计学意义,干预后实验组总白蛋白、转铁蛋白、前白蛋白均高于对照组,差异有统计学意义(P<0.05或0.01)。结论综合营养护理干预有助于改善老年管饲患者的营养状况。Objective To explore the effect of multiplex nutritional nursing intervention on the mild and moderate malnutrition of aged tube-feeding patients. Methods One hundred and twenty cases of tube-feeding patients were randomly divided into two equal groups： experimental and control group with 60 cases in each. Routine nursing care was provided in the control group. And multiplex nutrinonal nursing intervention combined with routine nursing care was applied in the experimental group for a month. The intervention taken in multiplex nutritional nursing included systematic training for nurses on tube-feeding and nutrition, establishing a nutrinon support team （NST） comprised of physicians, nurses and dietitians to make individualized nurtrition plan for patient,changing the length of the inserted tube. fixing gastrostomy and nasogastnc tube. using color pictures and models of food to stimulate the appetite of patients and promote digestion and absorpuon, assisting patients in assuming semi-reclining position during tube-feeding and at least 30 minutes after feeding, training patients swallow function and providing health educaiton on discharge and during home visit. Results There was no significant differenc in subjective and objective assessment on nutritional status among investigated aged patients betweem two groups before intervention. But after intervention, the results of subjective evalutaion on nutritional status in experimental group were significantly better than that in control group（ P 〈0.05）and total albumin, albumin, transferrin and prealbumin measured in experimental group were all significantly higher than that in control group（ P 〈0. 05 or 0. 01）. Conclusion The multiplex nutritional nursing intervention could help improve the nutritional status of aged tube-feeding patients.

关 键 词：老年 管饲 营养 护理干预 

分 类 号：R459.3[医药卫生—治疗学]