三种免疫营养制剂在老年压疮防治中的应用比较  

Comparison of Three Immune Nutrition Preparations Used in Prevention and Treatment of Pressure Ulcers in the Elderly

作　　者：王艳[1] 熊毅敏[1] 陈慧敏[1] 袁方[1] 徐维田[1] 

机构地区：[1]广州军区武汉总医院消化内科,湖北武汉430070

出　　处：《华南国防医学杂志》2015年第9期657-659,665,共4页Military Medical Journal of South China

基　　金：湖北省自然科学基金资助项目(2012FFB06806);湖北省卫生厅2013-2014年度科研项目(HL2012-8)

摘　　要：目的比较ω-3鱼油脂肪乳、丙氨酰谷氨酰胺及复方氨基酸三种免疫营养制剂对老年压疮的干预作用。方法 Waterlow压疮危险评估表和营养风险筛查(nutrition risk screening,NRS2002)评估为压疮且有营养风险的老年患者502例,年龄≥60岁,禁食及卧床时间≥5d,按回顾性队列研究设计,分为无免疫营养干预组、丙氨酰谷氨酰胺组(A组)、复方氨基酸组(B组)、ω-3鱼油脂肪乳组(C组)、A+B组、B+C组、A+B+C组,χ2检验分析免疫营养制剂应用与否对老年压疮发生率的影响,逐步logistic回归分析免疫营养制剂对老年压疮的干预效果。结果应用免疫营养制剂与否组间压疮发生率比较差异有统计学意义(χ2=33.347,P<0.01)。使用免疫营养制剂可降低压疮发生相对危险度,其中ω-3鱼油脂肪乳为5.53倍,丙氨酰谷氨酰胺为4.35倍,复方氨基酸为1.77倍。但各组交互效应不显著。结论准确的压疮及营养评估后,及时给予三种免疫营养制剂干预,可阻止或延缓老年高危人群压疮的发生,其中ω-3鱼油脂肪乳效果最优,丙氨酰谷氨酰胺次之,复方氨基酸较前两者效果差。Objective To compare the effects of three immune nutrition preparations,rich inω-3 polyunsaturated fatty acids,alanyl glutamine and amino acid compound respectively,on pressure ulcers.Methods A total of 502 elderly patients who were over 60 years old,fasted and bedridden for over 5 days and also accessed to have nutritional risk by Waterlow pressure sore risk assessment tool and nutrition risk screening 2002（NRS2002）,were assigned to seven groups based on retrospective cohort study-control group（no nutrition）,alanyl glutamine group（A group）,amino acid compound group（B group）,ω-3 polyunsaturated fatty acids group（C group）,A＋B group,B＋C group and A＋B＋C group.χ2 square test and stepwise logistic regression were applied to analyse the effect of immune nutrition preparations on pressure ulcers.Results The effect of immune nutrition preparations was significantly different based on chi-square test（χ2=33.347,P〈0.01）.The odd ratio was reduced by 5.35 times by usingω-3 fatty acids,by 4.35 times by using alanyl glutamine and by1.77 times by using amino acid compound based on the coefficient in the stepwise logistic regression while the interaction effects of any two nutrition preparations were not significantly different.Conclusion Intervention by three nutrition preparations timely pressure ulcer assessment and related nutritional assessment can delay or avoid pressure ulcer in the elderly.Among the nutrition preparations,ω-3 polyunsaturated fatty acids has the best performance,alanyl glutamine comes the second while amino acid compound is the worst.

关 键 词：压疮 老年人 Ω-3鱼油脂肪乳 丙氨酰谷氨酰胺 复方氨基酸 

分 类 号：R632.1[医药卫生—外科学]