针对性免疫营养干预对临床高龄高危压疮患者防治效果的观察  

Research of Targeted Immune Nutrition Intervention on Elderly Patients with High-risk of Pressure Ulcers

作　　者：王艳 周守凤 陈慧敏 WANG Yan;ZHOU Shoufeng;CHEN Huimin(Department of Sterilization Supply,General Hospital of Central Theater Command,Wuhan Hubei 430070,China)

机构地区：[1]中部战区总医院消毒供应科,湖北武汉430070 [2]中部战区总医院消化内科,湖北武汉430070

出　　处：《华南国防医学杂志》2019年第11期751-753,共3页Military Medical Journal of South China

基　　金：湖北省自然科学基金(2012FFB06806);湖北省卫生厅2013-2014年度科研项目(HL2012-8);湖北省卫生厅2017-2019年度科研项目(WJ2017H0049)

摘　　要：目的比较ω-3鱼油脂肪乳(ω-3 polyunsaturated fatty acids,ω-3 PUFA)、丙氨酰谷氨酰胺、复方氨基酸18AA及相互搭配组合对临床高龄高危患者压疮防治效果。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,年龄≥80岁的高龄患者402例,按回顾性队列研究设计,分为丙氨酰谷氨酰胺组(Ⅰ组)、复方氨基酸18AA组(Ⅱ组)、丙氨酰谷氨酰胺+复方氨基酸18AA组(Ⅲ组)、ω-3 PUFA组(Ⅳ组)、丙氨酰谷氨酰胺+ω-3 PUFA组(Ⅴ组)、丙氨酰谷氨酰胺+ω-3 PUFA+复方氨基酸18AA组(Ⅵ组)、无免疫营养干预(对照组)。采取图凯HSD检验法进行多重检验,将无显著差异的组间进行χ~2检验,观察免疫营养制剂各配方组间对老年高危高龄压疮发生率的影响。结果所有免疫营养干预组的压疮发病率均显著低于对照组;Ⅵ组压疮发生率最低;Ⅵ组显著好于Ⅱ组(P<0.01);但Ⅰ组、Ⅲ组、Ⅳ组、Ⅴ组、Ⅵ组两两比较差异无统计学意义(P>0.05)。结论临床治疗中及时给予ω-3 PUFA、丙氨酰谷氨酰胺免疫营养干预,既可阻止或延缓高危高龄患者压疮的发生,又可避免药物的不良反应及浪费。对于症状严重者,若使用丙氨酰谷氨酰胺+复方氨基酸18AA+ω-3 PUFA联合配方,干预效果更佳。Objective To compare the prevention and treatment effects of ω-3 polyunsaturated fatty acids(ω-3 PUFA),alanyl-glutamine, compound amino acid 18 AA, and their combination on elderly patients with high-risk of pressure ulcers.Methods A total of 402 patients aged ≥80 years were enrolled in the study. The pressure ulcers and nutritional risk were evaluated by Waterlow pressure ulcer risk screening and nutrition risk screening(NRS2002). According to the retrospective cohort study design, all patients were divided into alanyl-glutamine group(group Ⅰ), compound amino acid 18 AA group(group Ⅱ), alanyl-glutamine+compound amino acid 18 AA group(group Ⅲ),ω-3 PUFA group(group Ⅳ),alanyl-glutamine+ω-3 PUFA group(group Ⅴ),alanyl-glutamine+compound amino acid 18 AA +ω-3 PUFA group(group Ⅵ), and without immune nutrition intervention(control group).The multiple test was dectected by Tukey HSD test, among groups without significant differences were dectected by Chi-square test, the effects of different formulations of immune nutrition agents on the incidence of pressure ulcers in the elderly with high risk were compared.Results The incidence of pressure ulcers in all immune nutrition intervention groups were significantly better than those in control groups(P<0.01).The incidence of pressure ulcers in group Ⅵ was the lowest,the incidence of pressure ulcers in group Ⅵ was significantly better than that in group Ⅱ(P<0.01);but the incidence of pressure ulcers of group Ⅰ, group Ⅲ, group Ⅳ, group Ⅴ and group Ⅵ were not significantly different compared to each other(P>0.05).Conclusion Immune nutritional intervention with ω-3 PUFA and alanyl-glutamine can prevent or delay the occurrence of pressure ulcers in elderly patients who were in high-risk, and avoid adverse reactions and waste of drugs. Combined formula of alanyl-glutamine+ compound amino acid 18 AA+ω-3 PUFA may have better intervention effects on the patients with severe symptoms.

关 键 词：压疮 高龄患者 Ω-3鱼油脂肪乳 丙氨酰谷氨酰胺 复方氨基酸 

分 类 号：R493[医药卫生—康复医学]