基于营养风险筛查的个性化营养支持对炎症性肠病患者营养状态及预后的影响  

Effect of personalized nutritional support based on nutritional risk screening on nutritional status and prognosis of patients with inflammatory bowel disease

作　　者：吴旭桃 潘建丹 石玲燕[1] 赵秋[2] 邱雯慧 Wu Xutao;Pan Jiandan;Shi Lingyan;Zhao Qiu;Qiu Wenhui(Department of Gastroenterology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China;Department of Emergency,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属第一医院消化科,温州325000 [2]温州医科大学附属第一医院急诊科,温州325000

出　　处：《中国基层医药》2024年第5期715-721,共7页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市科技计划 (Y20210478)。

摘　　要：目的观察基于营养风险筛查的个性化营养支持对炎症性肠病患者营养状态及预后的影响。方法前瞻性选取2021年1月至2022年9月温州医科大学附属第一医院消化内科收治的炎症性肠病(IBD)患者100例为研究对象,按照随机数字表法分为对照组及观察组,对入组的患者均开展NRS 2002营养风险评估,对照组予以常规护理及营养支持方案,观察组在此基础上进行以“患者为中心”的医护患共享的个性化营养支持方案。观察比较两组患者在入院时、出院时、出院后1个月、出院后3个月的营养状态、炎症指标及疾病预后情况。结果在入院至出院后3个月内,两组患者的白蛋白(ALB)、前白蛋白(PAB)、氮平衡、肱三头肌皮褶厚度(TST)均明显升高,差异均有统计学意义(F=8.43、14.32、10.27、23.41、7.66、8.91、6.84、8.90,均P<0.05),营养不良炎症-评分(MIS评分)明显降低,差异均有统计学意义(F=4.84、7.42,P<0.05),观察组患者在出院后3个月时的ALB、PAB、氮平衡、TST明显高于对照组,差异均有统计学意义(t=7.95、17.43、6.55、6.72,均P<0.001),MIS评分明显低于对照组,差异有统计学意义(t=6.95,P<0.001);随着治疗的进行,两组患者的C反应蛋白(CRP)、粪便钙卫蛋白(FCP)水平较入院时逐渐降低,红细胞沉降率(ESR)减慢,差异均有统计学意义(F=9.03、11.28、18.37、19.20、32.42、28.88,均P<0.001),出院后3个月时观察组患者的CRP、FCP、ESR水平均明显低于对照组,差异均有统计学意义(t=8.29、7.99、10.34,均P<0.001);观察组患者对制定的饮食方案依从性较好,未发生相关拒绝性事件,观察组患者的再入院率明显低于对照组,差异有统计学意义(χ^(2)=10.18,P<0.05)。结论基于营养风险筛查的个性化营养支持方案有助于改善IBD患者的营养状况及疾病状态。Objective To explore the effect of personalized nutritional support based on nutritional risk screening on nutritional status and prognosis of patients with inflammatory bowel disease.Methods A total of 100 patients with inflammatory bowel disease admitted to the Department of Gastroenterology,The First Affiliated Hospital of Wenzhou Medical University from January 2021 to September 2022 were selected as the study objects,and were divided into control group and observation group according to the random number method.NRS 2002 nutritional risk screening was performed on all patients.The control group was given routine nursing and nutritional support.On this basis,the observation group received patient-centered personalized nutrition support program shared by doctors and patients.The nutritional status,inflammatory indicators and prognosis of the two groups were compared and observed at admission,discharge,1 month after discharge,and 3 months after discharge.Results From admission to 3 months after discharge,albumin,prealbumin,nitrogen balance,triceps skinfold thickness in the two groups were significantly increased(F=8.43,14.32,10.27,23.41,7.66,8.91,6.84,8.90,P<0.05),while the malnutrition inflammation score was significantly decreased(F=4.84,7.42,P<0.05).Albumin,prealbumin,nitrogen balance,triceps skinfold thickness in the observation group were significantly higher than those in the control group at 3 months after discharge(t=7.95,17.43,6.55,6.72,P<0.001),and the malnutrition inflammation score was significantly lower than that of the control group(t=6.95,P<0.001).As treatment progressed,the levels of C-reactive protein and fecal calprotectin gradually decreased and the erythrocyte sedimentation rate slowed down in both groups compared with the admission,with statistical significance(F=9.03,11.28,18.37,19.20,32.42,28.88,P<0.001).The levels of C-reactive protein and fecal calprotectin and erythrocyte sedimentation rate in the observation group were significantly lower than those in the control group 3 months after

关 键 词：肠道营养 结肠炎 溃疡性 营养支持 白蛋白类 血沉 

分 类 号：R473.5[医药卫生—护理学]