围手术期口服营养补充对老年股骨转子间骨折术后营养状况及生活质量的影响  

Effects of perioperative oral nutrition supplement on nutritional status and quality of life after femoral intertrochanteric fracture in the elderly

作　　者：高卉[1] 吕蓓蓓 李琳[1] 朱峰[1] 周军 徐耀增[1] 冯晓兰[1] GAO Hui;LU Bei-bei;LI Lin;ZHU Feng;ZHOU Jun;XU Yao-zeng;FENG Xiao-lan(Department of Orthopedics,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《肠外与肠内营养》2018年第5期296-300,共5页Parenteral & Enteral Nutrition

基　　金：国家自然科学基金资助项目(81672238;81472077)

摘　　要：目的 :探讨围手术期口服营养补充对老年股骨转子间骨折病人术后营养状况及生活质量的影响。方法 :选取采用闭合复位髓内固定治疗的老年股骨转子间骨折病人60例随机分为对照组和实验组。对照组给予常规饮食指导;实验组在原有普通饮食的基础上口服肠内营养粉剂。术后比较两组营养状况、胃肠道并发症、首次下床活动时间、日常生活能力(Barthel评分表)及住院天数的差异。结果:肠内营养干预组术后总蛋白、血清白蛋白和前白蛋白的含量、营养风险评分、围手术期食物每日摄入的热量、蛋白含量与对照组比较,差异有统计学意义(P <0.05)。胃肠道并发症(便秘)发生例数实验组与对照组比较,差异无统计学差异(P> 0.05)。肠内营养干预后,病人平均首次下床时间提前了4.5 h,住院时间缩短了0.53 d,生活能力评分提高了6.84分,差异有统计学意义(P <0.05)。两组术前营养潜在风险病人在术后总蛋白、白蛋白、前白蛋白、生活能力评分、下床时间和住院天数差异有统计学意义(P <0.05)。结论 :老年股骨转子间骨折病人围手术期使用肠内营养制剂可改善病人术后营养状况,提高病人术后生活质量。Objective： To investigate the effect of perioperative oral nutrition supplement（ONS） on nutritional status and quality of life in elderly patients with femoral intertrochanteric fracture. Methods： Sixty patients with intertrochanteric fractures treated by closed replacement and intramedullary fixation were randomly divided into control group and experimental group. The control group（30 cases） were given routine nursing and diet guidance after admission; the experimental group（30 cases） were treated with prophylactic use of ONS in addition to of the original diet. After the operation, the difference of nutritional status, gastrointestinal complications, time to first ambulance, and the ability of daily living（Barthel score） and postoperative hospital stay between the two groups were compared. Results： The serum levels of postoperative total protein, serum albumin and pre-albumin, the postoperative nutritional risk score, calorie and protein intake of patients in experimental group were significantly higher compared to control group（P〈0.05）. There was no significant difference in the incidence of gastrointestinal complications（constipation） between the two groups. Compared with the control group, time to first ambulance was decreased by 4.5 hours, the length of stay in hospital was shortened by 0.53 days, and the living ability score increased by 6.84 points, the difference was all statistically significant（P 0.05）. Conclusion： The use of oral nutrition supplement can improve the postoperative nutritional status of elderly patients with femoral intertrochanteric fracture during the perioperative period, and improve the quality of life of patients after operation.

关 键 词：肠内营养 老年 股骨间骨折 营养状况 

分 类 号：R59[医药卫生—内科学] R683[医药卫生—临床医学]