强化营养支持对老年内科危重患者住院期间发生静脉血栓栓塞的预防价值  

Preventive value of strengthening nutritional support for venous thromboembolism in critically ill elderly patients during hospitalization

作　　者：沈丽丽[1] 蒋宵 孙才智[1] 梁钰[1] Shen Lili;Jiang Xiao;Sun Caizhi;Liang Yu(Emergency Medical Ward,Nanjing First Hospital,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)急诊内科病房,江苏南京210000

出　　处：《血管与腔内血管外科杂志》2024年第10期1216-1219,1253,共5页Journal of Vascular and Endovascular Surgery

基　　金：2022年度南京市卫生科技发展专项资金项目(YKK22115)。

摘　　要：目的探讨强化营养支持对老年内科危重患者住院期间发生静脉血栓栓塞(VTE)的预防价值。方法收集2021年1月至2023年10月于南京医科大学附属南京医院(南京市第一医院)住院治疗的138例老年内科危重症患者的临床资料。根据住院期间是否接受了强化营养支持将患者分为强化组(n=65)和对照组(n=73)。比较两组患者住院期间的疾病类型和主要治疗情况,VTE的发生情况,病死率以及出院时的老年营养风险指数(GNRI)。结果强化组患者实施踝泵运动和早期下床活动(入院后7 d内)的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。住院期间,强化组患者VTE的发生率为0,低于对照组患者的9.6%(7/73),差异有统计学意义(P﹤0.05)。对照组中,肺栓塞(PE)患者2例,下肢深静脉血栓(LEDVT)患者5例。住院期间共16例患者死亡,其中,强化组患者的病死率为4.6%(3/65),低于对照组患者的17.8%(13/73),差异有统计学意义(P=0.016)。强化组和对照组患者出院时的GNRI均高于本组入院时,且强化组患者出院时的GNRI高于对照组患者,差异均有统计学意义(P=0.003)。结论强化营养支持可以改善老年内科危重症患者的营养状态,降低住院期间VTE的发生率和病死率,值得临床推广并进一步深入研究。Objective To investigate the preventive value of strengthening nutritional support for venous thromboembolism(VTE)in critically ill elderly patients during hospitalization.Method The clinical data of 138 critically ill elderly patients admitted to Nanjing First Hospital for treatment from January 2021 to October 2023 were collected.According to whether they received enhanced nutritional support during hospitalization,the patients were divided into enhanced group(n=65)and control group(n=73).The disease types and main treatment outcomes during hospitalization,incidence of VTE,mortality rate,and geriatric nutritional risk index(GNRI)at discharge between two groups of patients were compared.Result The proportion of patients who underwent ankle pump exercise and early mobilization(within 7 days after admission)in the enhanced group was higher than that in the control group,and the differences was statistically significant(P<0.05).During hospitalization,the incidence of VTE in the enhanced group was 0,which was lower than the 9.6%(7/73)in the control group,and the difference was statistically significant(P<0.05).In the control group,there were 2 patients with pulmonary embolism(PE)and 5 patients with low extremity deep vein thrombosis(LEDVT).During hospitalization,a total of 16 patients died.Among them,the mortality rate of the enhanced group patients was 4.6%(3/65),which was lower than the 17.8%(13/73)of the control group patients,and the difference was statistically significant(P=0.016).The GNRI of patients in the enhanced group and the control group at discharge were higher than those of patients in this group at admission,and the GNRI of patients in the enhanced group at discharge was higher than that of patients in the control group,and the differences were statistically significant(P=0.003).Conclusion Strengthening nutritional support can significantly improve the nutritional status of elderly critically ill patients in internal medicine,reduce the incidence and mortality of VTE during hospitalization,and is wor

关 键 词：营养支持 老年 内科 危重症 静脉血栓栓塞 预防 

分 类 号：R543[医药卫生—心血管疾病]