乙型肝炎肝硬化失代偿期患者营养评估及营养支持效果  

Nutritional assessment and nutritional support effect in patients with hepatitis B virus-related decompensated cirrhosis

作　　者：逯凯 徐晶 邬菊英 LU Kai;XU Jing;WU Juying(Department of Hepatology,Xixi Hospital of Hangzhou,Hangzhou 310023,China)

机构地区：[1]杭州市西溪医院肝病科,浙江杭州310023

出　　处：《中国现代医生》2022年第17期94-97,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY534)。

摘　　要：目的 探讨乙型肝炎肝硬化失代偿期(DSC)患者进行营养评估和综合营养支持的效果。方法 选取2019年1月~2020年10月杭州市西溪医院收治的乙型肝炎DSC患者96例,按随机数字表法,将其分为对照组和观察组,每组各48例。对照组给予常规膳食营养支持,观察组给予全面营养评估和综合营养支持疗法,比较两组治疗后的ALT、TBIL、PTA、血红蛋白、白蛋白、营养筛查评分、并发症发生率等。结果 (1)治疗后,观察组的TBIL水平[(23.65±4.93)μmol/L]低于对照组[(47.48±6.30)μmol/L](P<0.05),PTA水平[(51.39±7.62)%]高于对照组[(45.80±7.34)%](P<0.05);(2)观察组的血红蛋白[(10.53±3.61)g/dl]、白蛋白[(34.59±5.44)g/L]水平均高于对照组[(8.65±2.49)g/dl、(29.68±5.72)g/L](均P<0.05),营养筛查评分[(2.35±0.59)分]低于对照组(3.08±0.65)分,(P<0.05);(3)观察组的食欲减退(33.33%)、腹水(41.67%)、乏力(39.58%)、双下肢水肿(35.42%)等并发症发生率均低于对照组(70.83%、81.25%、66.67%、60.42%)(均P<0.05)。结论 乙型肝炎DSC患者进行全面营养评估和综合营养支持后,可提高机体营养状态,改善肝脏功能,降低并发症发生率,值得在临床推广应用。Objective To investigate the nutritional assessment and comprehensive nutritional support effect in patients with hepatitis B virus(HBV)-related decompensated cirrhosis(DSC). Methods A total of 96 patients with HBV-related DSC treated in our hospital from January 2019 to October 2020 were randomly divided into the control group(n=48)and the observation group(n=48). The control group was given conventional dietary nutritional support, while the observation group was given comprehensive nutritional assessment and comprehensive nutritional support. The alanine transaminase(ALT), total bilirubin(TBIL), prothrombin activity(PTA), hemoglobin, albumin, nutritional screening score and the incidence of complications were compared between the two groups. Results(1) After treatment, the level of TBIL in the observation group [(23.65±4.93)μmol/L] was lower than that in the control group [(47.48±6.30)μmol/L](P<0.05), while the level of PTA in the observation group [(51.39 ±7.62)% ] was higher than that in the control group[(45.80±7.34)%](P<0.05).(2)The levels of hemoglobin and albumin in the observation group [(10.53 ±3.61)g/dl and(34.59±5.44)g/dl] were higher than those in the control group [(8.65±2.49)g/dl and(29.68±5.72)g/dl](all P<0.05), while the nutritional screening score in the observation group [(2.35 ±0.59)points] was lower than that in the control group[(3.08±0.65)points](P<0.05).(3)The incidence of complications such as anorexia(33.33%), ascites(41.67%), fatigue(39.58%) and edema of both lower limbs(35.42%) in the observation group was respectively lower than those in the control group(70.83%, 81.25%, 66.67% and 60.42%)(all P<0.05). Conclusion The comprehensive nutritional assessment and comprehensive nutritional support can improve the nutritional status, improve liver function and reduce the incidence of complications of patients with HBV-related DSC, which is worthy of clinical application.

关 键 词：乙型肝炎 肝硬化 失代偿期 营养评估 营养支持 

分 类 号：R512.62[医药卫生—内科学]