基于护士为主导的多学科团队营养干预方案的构建及对住院老年人营养水平的影响  

Development of nurse-led multidisciplinary team nutritional intervention program and its impact on nutritional status of hospitalized elderly patients

作　　者：杨胜男 项金华 付丽 钟艳 彭叶文 YANG Sheng-nan;XIANG Jin-hua;FU Li;ZHONG Yan;PENG Ye-wen(Department of Geriatrics,the Third Hospital of Changsha,Changsha 410000,Hunan,China)

机构地区：[1]长沙市第三医院老年医学科,湖南长沙410000

出　　处：《广东医学》2023年第9期1067-1073,共7页Guangdong Medical Journal

基　　金：湖南省卫生健康委科研计划项目(202114011464)。

摘　　要：目的建立基于护士为主导的多学科团队营养干预方案,研究该干预方案对住院老年人营养水平的影响。方法以2022年1—6月在医院住院治疗的118例老年患者为研究对象,按照随机数字表法分为对照组和观察组,每组59例。对照组患者按照常规营养干预模式,观察组患者进行基于护士为主导的多学科团队营养干预方案,在干预前和患者出院时采用营养风险筛查2002量表(nutritional risk screening 2002,NRS 2002)和微型营养评定量表(mini nutritional assessment short-form,MNA-SF)筛查营养风险;记录两组患者干预期间的喂养达标率、喂养中断率、住院时间、不良事件发生率以及干预前后营养指标,采用修订版的胃瘫主要症状指数(gastroparesis cardinal symptom index revised,GCSI-R)量表评估胃肠功能。结果干预后,观察组患者的NRS 2002评分更低[(2.91±0.67)分vs.(4.22±1.05)分],MNA-SF评分更高[(11.73±1.86)分vs.(9.46±1.79)分](P<0.05)。观察组患者的喂养达标率明显更高,喂养中断率更低,住院时间明显更短(P<0.05)。与对照组比较,观察组患者的白蛋白、血红蛋白水平明显更高,转铁蛋白、C-反应蛋白水平明显较低,骨骼肌、无机盐、骨矿物质含量明显更高,体脂含量明显更低,差异有统计学意义(P<0.05)。观察组患者GCSI-R量表评分各维度及量表总分均显著低于对照组患者(P<0.05)。观察组患者呕吐、腹泻/便秘、误吸、胃肠功能不全、消化道出血等症状的发生率明显低于对照组患者(P<0.05)。结论为住院老年患者构建基于护士为主导的多学科团队营养干预方案能显著改善患者营养状况和胃肠功能,提高患者生理功能,显著降低营养支持期间不良事件发生率,该种营养干预方案具有重要临床应用价值。Objective To establish a nurse-led multidisciplinary team nutrition intervention program and study its effect on the nutritional level of hospitalized elderly patients.Methods A total of 118 elderly patients who were hospitalized from January to June,2022 were selected.According to the random number table method,they were assigned into control group and observation group,with 59 cases in each group.Patients in the control group were treated with routine nutritional intervention mode,while patients in the observation group were treated with nurse-led multidisciplinary team nutritional intervention program.Nutritional Risk Screening 2002(NRS 2002)and Mini Nutritional Assessment Short-form(MNA-SF)were used to screen nutritional risk.The feeding compliance rate,feeding interruption rate,length of hospital stay and incidence of adverse events were recorded.The nutritional indexes and the gastrointestinal function was evaluated by the revised Gastroparesis Cardinal Symptom Index Revised(GCSI-R)scale.Results After intervention,the NRS 2002 score of the observation group was significantly lower(2.91±0.67 vs.4.22±1.05),and the MNA-SF score was significantly higher(11.73±1.86 vs.9.46±1.79)(P<0.05).In the observation group,the rate of feeding compliance was significantly higher,the rate of feeding interruption was significantly lower,and the length of hospital stay was significantly shorter(P<0.05).The levels of albumin and hemoglobin in the observation group were significantly higher,the levels of transferrin and C-reactive protein were significantly lower,the contents of skeletal muscle,inorganic salts and bone minerals were significantly higher,and the content of body fat was significantly lower than those in control group(P<0.05).The score dimensions and total score of GCSI-R in the observation group were significantly lower than those in the control group(P<0.05).The incidences of vomiting,diarrhea/constipation,aspiration,gastrointestinal insufficiency,gastrointestinal bleeding and other symptoms in the observation

关 键 词：多学科团队 营养干预 住院老人 护士主导 营养风险筛查 

分 类 号：R151[医药卫生—营养与食品卫生学] R459.3[医药卫生—公共卫生与预防医学]