摘要
目的了解老年肺结核患者营养状况并分析其影响因素,为临床医护人员实施个体化营养干预提供参考。方法选取2018年3-8月收治于上海市肺科医院结核科的老年肺结核患者作为调查对象,采用一般资料调查问卷、微型营养评定法(Mini Nutritional Assessment,MNA)、24 h膳食回顾(连续3 d)、食物频率调查(3个月内)、焦虑自评量表、社会支持量表、家庭功能评定量表对患者进行调查。结果共调查老年肺结核患者134例,MNA营养评分(19.79±4.89)分。134例老年肺结核患者每日总能量、蛋白质、脂肪和碳水化合物摄入量均低于参考摄入量,多数维生素(维生素A、D、C、B_(1)、B_(2)和B_(6))及部分矿物质(钙、磷、碘和硒)每日摄入量均低于中国居民膳食营养素参考摄入量。单因素分析结果显示,不同性别、居住情况、患病情况、服药情况、耐药状况患者的MNA营养评分存在差异(P<0.05)。多元线性回归分析显示,耐药状况、服药状况、家庭功能状况、营养素摄入量及膳食结构是老年肺结核患者营养状况的重要影响因素。结论老年肺结核患者的营养状况不容乐观,存在多种营养素摄入不足、饮食结构欠合理等问题。建议临床医护人员及营养师针对老年肺结核患者营养不良的特点及膳食营养素的摄入状况,尽早实施临床营养管理工作,制订个体化、精准的营养干预方案,给予患者合理的膳食结构建议,纠正其营养不良,改善其营养状况。
ObjectiveTo understand the nutritional status of elderly patients with pulmonary tuberculosis and analyze the influencing factors,providing a reference for clinical workers to implement an individualized nutritional intervention.MethodsElderly patients with pulmonary tuberculosis admitted to the Tuberculosis Department of Shanghai Pulmonary Hospital from March to August 2018 were selected.They were investigated using the General Information Questionnaire,Mini Nutritional Assessment(MNA),24-hour Dietary Recall(for3 consecutive days),Food Frequency Questionnaire(within 3 months),Self-Rating Anxiety Scale,Social Support Scale and Family Assessment Device.ResultsA total of 134 elderly patients with pulmonary tuberculosis were investigated,with an MNA nutritional score of(19.79±4.89)points.For the 134 elderly patients with pulmonary tuberculosis,their daily total intakes of energy,protein,fat and carbohydrate were lower than the references,and their daily intakes of most vitamins(vitamins A,D,C,B_(1),B_(2)and B_(6))and some minerals(calcium,phosphorus,iodine and selenium)were lower than the references of dietary nutrients for Chinese residents.Univariate analysis showed that there were significant differences in MNA nutritional scores among patients with different gender,residence,prevalence,medication,and drug resistance(P<0.05)Multiple linear regression analysis showed that drug resistance,medication,family function,nutrient intake and dietary pattern were important influencing factors of nutritional status in elderly patients with pulmonary tuberculosis.Conclusion The nutritional status of elderly patients with pulmonary tuberculosis is not optimistic,because of their insufficient intake of multiple nutrients and unreasonable dietary pattern.Clinical workers and dietitians are recommended to carry out clinical nutrition management for elderly patients with pulmonary tuberculosis as early as possible according to their characteristics of malnutrition and intake of dietary nutrients.Individualized and accurate nutrition interventions should be planned to give patients reasonable suggestions on dietary patterns,correct their malnutrition and improve their nutritional status.
作者
陈丹萍
毛燕君
李敏
陈薇
丁芹
CHEN Danping;MAO Yanjun;LI Min;CHEN Wei;DING Qin(Shanghai Pulmonary Hospital,Tongji University,Shanghai 200433;Naval Medical University,Shanghai 200433)
出处
《上海护理》
2022年第4期38-43,共6页
Shanghai Nursing
基金
上海市肺科医院护理精英人才库项目(HL-A2)。
关键词
结核
肺
老年人
患者
营养不良
营养摄入
膳食结构
影响因素
Pulmonary tuberculosis
Elderly
Patients
Malnutrition
Nutritional intake
Dietary pattern
Influencing factor
