上海市长期照护机构吞咽障碍老年人营养状况调查分析  

Nutritional Status of the Elderly with Dysphagia in Long-term Care Facilities in Shanghai

作　　者：吴彩芳 李或 刘静 林娜 金杭梅 杨云华 陈艳秋[4] 谢华[4] 袁伟 孙建琴[4] Wu Caifang;LiHuo;Liu Jing;Lin Na;Jin Hangmei;Yang Yunhua;Chen Yanqiu;Xie Hua;Yuan Wei;Sun Jianqin(Yingyuan Hospital of Jiading District,Shanghai,201822;Shanghai Donghai Geriatric Nursing Hospital,Shanghai 201303;The Social Welfare Institute of Minhang District,Shanghai,201199;Huadong Hospital Affiliated to Fudan University,Shanghai,200040;Zhabei Central Hospital,Jing-an District,Shanghai,200070,P.R.China)

机构地区：[1]上海市嘉定区迎园医院,上海201822 [2]上海市东海老年护理医院,上海201303 [3]上海市闵行区社会福利院,上海201199 [4]复旦大学附属华东医院,上海200040 [5]上海市静安区闸北中心医院,上海200070

出　　处：《老年医学与保健》2019年第6期849-852,共4页Geriatrics & Health Care

基　　金：中国营养学会营养科研基金——帝斯曼专项科研基金(2015-017);上海市嘉定区卫生计划委员会科研课题资金(2016-KY-25)

摘　　要：目的了解上海市长照机构中吞咽障碍老年人的营养素摄入及营养状况,为改善长照机构吞咽障碍老年人的营养状况提供科学依据。方法在上海三家长照机构中,采用洼田饮水试验对600例65岁以上老年人进行吞咽功能评估,根据评定结果将老人分为吞咽正常(n=203)和吞咽障碍(n=397)2组;采用24h膳食回顾法结合称重法进行连续3d的膳食调查并进行营养素摄入状况的分析;采用微型营养评定法简表评价营养状况;空腹采静脉血,测量血红蛋白、淋巴细胞计数、血清总蛋白、血清白蛋白、血清前白蛋白、铁蛋白、血清铁等与营养相关的实验室指标。并对两组老人的相关指标进行比较。结果与吞咽正常组比,吞咽障碍组老人的蛋白质、钙、镁、磷摄入量、总蛋白、白蛋白、前白蛋白水平明显较低,差异有统计学意义(均P<0.05);营养不良发生率较高,其中吞咽正常老人发生率为6.9%,吞咽困难老人发生率为17.1%。结论上海市长照机构中吞咽障碍老年人蛋白质、钙、镁、磷摄入减少、易出现营养不良。Objective To investigate the nutrient intake and nutritional status of the elderly with dysphagia in the longterm care facilities in Shanghai so as to provide basis for improvement.Methods The swallowing function of 600 elderly over 65 years old in 3 long-term care facilities in Shanghai with Kubota Toshiro drinking water test and based on the results of the test,the elderly were divided into 2 groups:normal swallowing group(n=203) and dysphagia group(n=397);dietary survey and nutrients intake analysis of the elderly in 3 consecutive days were performed with 24-hour diet recall method and weighing method;the nutritional status of the elderly was evaluated with the scale of Mini Nutritional Short-Form(MNA-SF);fasting venous blood samples of all the elderly were collected and the nutrition-related lab index were detected including the levels of hemoglobin,lymphocyte,serum total protein,serum albumin,serum prealbumin,ferritin,serum iron and a comparison of the related index was made between the 2 groups.Results The intake of protein,calcium,magnesium,phosphorus and the levels of total protein,albumin and prealbumin of the elderly in dysphagia group were less and lower than those of the elderly in normal swallowing group(P<0.05);the rate of malnutrition in the 2 groups was high,6.9% in normal swallowing group and 17.1% in dysphagia group.Conclusions There exists a decrease in the intake of protein,calcium,magnesium and phosphorus in the elderly with dysphagia in long-term care facilities in Shanghai,and malnutrition is easy to occur.

关 键 词：长期照护机构 吞咽障碍 老年人 营养素 营养状况 

分 类 号：R47[医药卫生—护理学]