个体化营养支持对老年骨质疏松性髋部骨折患者术后白蛋白水平及康复质量的影响  

Effect of Individualised Nutritional Support on Postoperative Albumin Levels and Quality of Rehabilitation in Elderly Osteoporotic Hip Fracture Patients

作　　者：琚绍静 臧砚超 梁卫东[1] 杨丽[1] 夏艳玲 刘伟 JU Shao-jing;ZANG Yan-chao;LIANG Wei-dong;YANG Li;XIA Yan-ling;LIU Wei(Tangshan Second Hospital,Department of Trauma,Tangshan 063000,China;Department of Hand and Foot Surgery,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]唐山市第二医院创伤一科,河北唐山063000 [2]华北理工大学附属医院手足外科,河北唐山063000

出　　处：《中国食物与营养》2025年第3期91-96,共6页Food and Nutrition in China

摘　　要：目的:观察个体化营养支持对老年骨质疏松性髋部骨折患者术后白蛋白水平及康复质量的影响。方法:选取2020年8月-2023年10月收治的老年骨质疏松性髋部骨折患者120例,采用信封法分为两组。两组均给予手术治疗,常规组术后给予常规对症治疗,个体化组在常规基础上给予个体化营养支持干预。比较两组主动功能锻炼开始时间、首次下床时间、患肢肿胀消退时间、住院时间、营养指标、营养风险筛查评分简表(NRS 2002)评分、Harris评分、骨代谢指标、并发症发生率。结果:个体化组主动功能锻炼开始时间(1.82±0.74)d、首次下床时间(5.47±1.88)d、患肢肿胀消退时间(12.38±2.54)d、住院时间(11.32±2.08)d均短于常规组(P<0.05)。干预前,两组营养指标、骨代谢指标比较无差异(P>0.05)。干预后,两组骨特异性碱性磷酸酶(BALP)、Ⅰ型前胶原羧基末端肽(PICP)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)均较干预前升高,且个体化组干预后高于常规组(P<0.05)。干预后,两组抗酒石酸酸性磷酸酶5b(sTRACP5b)、Ⅰ型胶原交联C-末端肽(CTX)均较干预前降低,且个体化组干预后低于常规组(P<0.05)。干预前,两组NRS 2002评分、Harris评分比较无差异(P>0.05)。干预后,两组Harris评分均较干预前升高,且个体化组干预后高于常规组(P<0.05)。干预后,两组NRS 2002评分均较干预前降低,且个体化组干预后低于常规组(P<0.05)。个体化组坠积性肺炎、下肢深静脉血栓、褥疮等并发症发生率与常规组比较,无差异(P>0.05)。结论:个体化营养支持用于老年骨质疏松性髋部骨折可改善营养状况和骨代谢指标,提高康复质量。【Objective】To observe the effect of individualised nutritional support on postoperative albumin levels and quality of rehabilitation in elderly patients with osteoporotic hip fractures.【Method】Totally120 cases of elderly osteoporotic hip fracture patients admitted from August 2020 to October 2023 were selected and divided into two groups using the envelope method.Both groups were given surgical treatment,the conventional group was given routine postoperative symptomatic treatment,and the individualised group was given individualised nutritional support intervention on a routine basis.The two groups were compared in terms of active functional exercise start time,first time out of bed,time for swelling of the affected limb to subside,hospitalisation time,nutritional indexes,Nutritional Risk Screening Rating Scale(NRS 2002)score,Harris score,bone metabolism indexes,and complication rate【.Result】The start time of active functional exercise in the individualised group(1.82±0.74)d,the time of first getting out of bed(5.47±1.88)d,the time of swelling of the affected limb subsiding(12.38±2.54)d,and the time of hospitalisation(11.32±2.08)d were shorter than that of the conventional group(P<0.05).Before intervention,there was no difference in the comparison of nutritional indexes and bone metabolism indexes between the two groups(P>0.05).After intervention,bone-specific alkaline phosphatase(BALP),carboxy-terminal peptide of type Ⅰ pre-collagen(PICP),albumin(ALB),prealbumin(PA),transferrin(TRF)were higher in both groups compared with pre-intervention,and were higher than the conventional group in the individualised group after intervention(P<0.05).After intervention,anti-tartrate acid phosphatase 5b(sTRACP5b)and type Ⅰ collagen cross-linked C-terminal peptide(CTX)were lower in both groups compared to preintervention,and were lower in the individualised group than in the conventional group after intervention(P<0.05).Before intervention,there was no difference in the comparison of NRS 2002 score and Harris

关 键 词：个体化营养支持 老年 骨质疏松性髋部骨折 骨代谢 康复质量 营养状况 

分 类 号：R47[医药卫生—护理学]