摘要
目的 探讨围术期个体化营养干预对存在营养风险的高龄腰椎后路椎间融合术患者的影响。方法 选取2018年1月-2019年12月于首都医科大学宣武医院行腰椎后路椎间融合术的181例年龄>75岁的老年患者作为研究对象,将NRS2002≥3分的85例患者纳入干预组,NRS2002<3分的96例患者纳入对照组。对照组予以常规饮食宣教,患者根据自己的饮食模式及喜好自行订餐;干预组予以进一步营养评估,制定个体化营养治疗方案。比较两组的营养指标(血清总蛋白、白蛋白、前白蛋白及血红蛋白)、可能致术后低蛋白血症的潜在高危因素(是否伴随糖尿病、衰弱状态、手术时间及术中出血量)及术后感染情况。结果 两组性别、病程、合并糖尿病比例及衰弱状态比较,差异均无统计学意义(P>0.05);干预组年龄高于对照组,体质量指数、术中出血量及术前血清总蛋白、白蛋白、前白蛋白、血红蛋白水平均低于对照组,手术时间短于对照组,差异均有统计学意义(P<0.05)。两组手术后血清总蛋白、白蛋白、前白蛋白及血红蛋白水平均较术前有所下降,干预组各指标的下降水平均低于对照组,差异均有统计学意义(P<0.05)。两组在住院时间及术后感染情况比较,差异均无统计学意义(P>0.05)。结论 对存在营养风险的行腰椎后路融合术的高龄患者进行术前营养干预,可减少术后营养指标的下降。
Objective To investigate the effect of perioperative individualized nutritional intervention on the changes of nutritional indicators and prognosis of elderly patients with nutritional risk after posterior lumbar interbody fusion.Methods From January 2018 to December 2019,a total of 181 elderly patients over 75 years old with posterior lumbar interbody fusion in Xuanwu Hospital Capital Medical University were included in this study.85 patients with≥3 points of NRS2002 were included in the intervention group,and 96 patients with<3 points of NRS2002 were included in the control group.The control group was given routine diet education,and the patients ordered meals according to their own dietary patterns and preferences.The intervention group was given further nutritional assessment and individualized nutritional treatment plan was developed.Nutritional indices(serum total protein,albumin,prealbumin and hemoglobin),potential risk factors for postoperative hypoproteinemia(whether diabetes mellitus,frailty,operative time and intraoperative blood loss)and postoperative infection were compared between the two groups.Results There were no significant differences in gender,course of disease,proportion of combined diabetes and frailty between the two groups(P>0.05).The age of the intervention group was higher than that of the control group,the body mass index,intraoperative blood loss,preoperative serum total protein,albumin,prealbumin and hemoglobin levels were lower than those of the control group,and the operation time was shorter than that of the control group,with statistical significance(P<0.05).The levels of serum total protein,albumin,prealbumin and hemoglobin in both groups were decreased after operation,but the levels of all indexes in the intervention group were lower than those in the control group,with statistical significance(P<0.05).There was no significant difference in length of hospital stay and postoperative infection between the two groups(P>0.05).Conclusion For elderly patients with nutritional risk,
作者
任晓艺
李旭颖
钱红娟
李缨
王朝东
Ren Xiaoyi;Li Xuying;Qian Hongjuan;Li Ying;Wang Chaodong(Department of Nutriology,Xuanwu Hospital Capital Medical University,National Clinical Research Center for Geriatric Disorders,Beijing 100053)
出处
《国际老年医学杂志》
2024年第3期274-277,共4页
International Journal of Geriatrics
基金
国家重点研发计划项目(2022YFC2009600,2022YFC2009601)。
关键词
营养干预
腰椎后路椎间融合术
营养指标
术后感染
住院时间
Nutritional intervention
Posterior lumbar interbody fusion
Nutritional index
Postoperative infection
Length of hospital stay
