糖尿病足病人营养风险与其临床预后及生存质量的关系  

Relationship between nutritional risk of patients with diabetic foot and their clinical prognosis and quality of life

作　　者：黄丽容[1] 吕丽雪[1] 劳美铃[1] 麦伟华[1] 誉昭红[1] 叶建红[1] HUANG Lirong;LYU Lixue;LAO Meiling;MAI Weihua;YU Zhaohong;YE Jianhong(Foshan Hospital of TCM,Guangdong 528000 China)

机构地区：[1]佛山市中医院,广东528000

出　　处：《护理研究》2020年第18期3296-3301,共6页Chinese Nursing Research

基　　金：佛山市卫生和计生局医学科研课题,编号:20190084。

摘　　要：[目的]探讨糖尿病足病人营养风险与其临床预后及生存质量的关系。[方法]选择2018年1月—2018年12月在佛山市中医院内分泌科住院治疗的319例糖尿病足病人作为研究对象,采用一般资料调查表、营养风险筛查简表(NRS 2002)、糖尿病特异性生存质量量表、临床预后调查表对病人进行调查,根据首次营养风险筛查结果将病人分为A组(NRS2002为0~2分)、B组(NRS2002为3分)、C组(NRS2002为4分或5分)、D组(NRS2002为6分或7分),比较4组病人实验室指标、生存质量和临床结局情况。[结果]319例糖尿病足病人中,193例(60.50%)病人无营养风险,126例(39.50%)病人有营养风险;有营养风险的病人中男性、年龄≥60岁、糖尿病病程>10年、糖尿病足病程>3个月、Wagner分级≥3级病人例数较多,创面面积大于无营养风险病人(P<0.05);随着营养风险分数升高,病人糖化血红蛋白、空腹血糖、餐后血糖等逐渐升高,体质指数、前清蛋白、清蛋白、血红蛋白浓度及白细胞计数呈逐渐下降趋势,4组病人比较差异有统计学意义(P<0.05);与A组病人相比,C组病人及D组病人足部溃疡愈合差,截肢发生率高,并发症发生率高,且D组病人与A组病人比较,死亡率高;A组病人生存质量总分及4个维度(生理功能、心理/精神功能、社会关系、治疗情况)得分均低于B组病人、C组病人、D组病人(P<0.05)。[结论]糖尿病足伴高度营养风险的病人年龄较大、病程较长、溃疡较重,并发症发生率较高,临床预后较差。Objective:To explore relationship between nutritional risk of patients with diabetic foot and their clinical prognosis and quality of life.Methods:Totally 319 hospitalized patients with diabetic foot in department of endocrinology in Foshan traditional Chinese medicine hospital,were selected as research subjects from January 2018 to December 2018.Patients were investigated by using general information questionnaires,Nutritional Risk Screening Briefs(NRS2002),Diabetes⁃Specific Quality of Life Scale,and clinical prognostic questionnaires.According to results of first nutritional risk screening,patients were divided into group A(score of NRS2002 as 0~2),group B(3 score of NRS2002),group C(score of NRS2002 as 4 or 5),group D(score of NRS2002 as 6 or 7).The laboratory indexes,quality of life and clinical outcomes of four groups were compared.Results:193(60.50%)patients among 319 patients had no nutritional risk,and 126(39.50%)patients had nutritional risk.The majority of patients at nutritional risk were males,with age≥60 years,and diabetes duration>10 years,foot disease course>3 months,Wagner grade≥3.Their would area were larger than patients without nutritional risk(P<0.05).As nutritional risk score increased,patients'glycosylated hemoglobin,fasting blood glucose,postprandial blood glucose increased,while,patients'body mass index,prealbumin,albumin,hemoglobin concentration and white blood cell count showed a gradual downward trend.Differences between four groups of patients were statistically significant(P<0.05).Compared with group A,patients in group C and group D had poorer foot ulcer healing,higher incidence of amputation,higher incidence of complications.Patients in group D had higher mortality rate compared with patients in group A.Total score and 4 dimensions(physical function,psychological/mental function,social relations and treatment)scores of quality of life in patients in group A were lower than those in group B,group C,and group D(P<0.05).Conclusions:Patients with diabetic foot at high nutritional

关 键 词：糖尿病足 营养风险 临床预后 生存质量 并发症 营养支持 

分 类 号：R473.58[医药卫生—护理学]