急慢性期脑卒中进食困难病人的营养状况调查研究  

Investigation on nutritional status of patients with difficulty in feeding during acute and chronic stroke

作　　者：张露[1] 蒋红[1] 张秀英[1] 周依群 容根南[3] 刘华华[1] 许雅芳[1] 陈莹[4] 朱雅萍 黄莺[1] 

机构地区：[1]复旦大学附属华山医院 [2]复旦大学附属静安区中心医院 [3]复旦大学附属华山北院宝山分院 [4]上海市第一人民医院分院 [5]上海市南京西路社区卫生服务中心

出　　处：《护理研究（上旬版）》2017年第11期3931-3935,共5页Chinese Nursing Researsh

基　　金：上海市卫生计生系统重要薄弱学科建设计划项目;编号:2015ZB0301;复旦大学护理科研基金项目;编号:FNF201511

摘　　要：[目的]探讨脑卒中后经口进食困难病人的营养现状。[方法]采用一般情况调查问卷、中文版微型进食观察表-Ⅱ(MEOF-Ⅱ)、微营养评价简表(MNA-SF)对上海市6所医院的266例脑卒中后经口进食困难病人进行调查。[结果]脑卒中后存在进食困难的病人中,61.3%存在营养不良及潜在营养不良,摄入困难组和精力/食欲下降组的营养状况差异有统计学意义(P<0.05),吞咽障碍组的营养状况差异无统计学意义(P>0.05);不同程度进食困难病人MNA-SF得分差异有统计学意义(P<0.01);脑卒中后的不同时期进食困难病人的营养状况差异也有统计学意义(P<0.01),脑梗死TOAST分型不同的病人营养状况也存在差异(P<0.05)。[结论]脑卒中后进食困难病人的潜在营养不良发生率高,营养状况改变的主要原因在于神经损伤造成了摄入困难和精力/食欲下降,脑梗死的病因分型不同,营养状况不同。Objective：To explore the nutritional status of patients with difficulty in feeding after stroke.Methods：A total of 266 patients with difficulty in feeding after stroke from 6 hospitals in Shanghai were investigated by general questionnaire,the Chinese version of Minimal-Eating Observation Form-version Ⅱ（MEOF-Ⅱ）and short-form Mini-nutritional Assessment（MNA-SF）.Results：Among the patients with difficulty in feeding after stroke,61.3% had malnutrition and potential malnutrition,the difference of nutritional status between the ingestion difficulty group and the appetite-loss group was statistically significant（P〈0.05）,the difference of nutrition status of swallowing disorder group was not statistically significant（P〈0.01）.There was a significant difference in the MNA-SF scores of patients with different levels of difficulty in feeding（P〈0.01）.There was also a significant difference in nutritional status of patients with difficulty in feeding at different times after stroke（P〈0.01）.There was significant difference in the nutritional status of patients with different cerebral infarction TOAST classification（P 〉0.05）.Conclusion：The risk of malnutrition was high in patients with difficulty in feeding after stroke.The main reason for the change of nutritional status was that nerve injury causing difficulty of ingestion and loss of appetite.The cause of cerebral infarction was different and the nutritional status was different too.

关 键 词：脑卒中 进食困难 营养评价 营养不良 摄入 食欲 影响因素 

分 类 号：R473.74[医药卫生—护理学]