老年住院患者营养状况及其影响因素分析

发布时间：2018-05-10 07:21

本文选题：营养不良 + 微量营养评价　；参考：《南方医科大学》2017年硕士论文

【摘要】：研究目的本次研究的主要目的是通过横断面研究调查广州市某三级甲等医院老年住院患者的营养状况,旨在研究广州市老年住院患者的营养状态,并探寻其相关影响因素,从而为医院医疗护理针对性的采取干预措施提供科学依据,提高老人健康水平。同时使老年人掌握营养知识,加强自身营养保健,改进老年人营养与健康状况,提高他们的生活质量,实现健康老龄化。研究方法本研究采用横断面调查方法,调查2016年1月-2016年7月期间在广州市某三级甲等医院的所有符合纳入、排除标准的60岁以上老年住院患者。主要应用结构化问卷收集研究对象的一般情况;生活习惯及健康状况;抑郁程度情况;日常活动能力(Activity of Daily Living,ADL)情况以及老年住院患者的营养状况,并通过体格测量和实验室检查获得人体测量学和血生化指标相关信息。原始数据使用SPSS 20.0统计软件进行录入、整理和分析。数据的整理分析使用频数、构成比、均数和标准差对调查结果进行统计描述。计数资料用构成比表示;对连续性变量进行正态性检验和方差齐性检验,服从正态分布的采用独立样本检验和方差分析,如不符合则采用Mann Whitney U检验和Kruskal-Wallis H检验;计数资料采用卡方检验。影响因素分析先用单因素检验筛选对营养状况影响有统计学意义的变量,再纳入多元逐步回归,用Ordial Logistic回归分析和多元回归分析。研究结果1、本研究调查了广州市某三级甲等医院的365名老年住院患者,其中男性215例(占比58.90%),女性150例(占比41.10%)。2、慢性病患病率高,本次研究中有97.53%的老年住院患者患有慢性病,其中18.36%的老年住院患者患一种慢性病,48.77%的老年住院患者患2-3种慢性病,30.41%的老年住院患者患≥4种慢性病;调查人群中高血压患病率为58.08%,糖尿病的患病率为50.14%。3、抑郁程度得分平均值为3.65,365名老年住院患者中,88人患有轻度抑郁,约占24.11%;23人患有重度抑郁者,约占6.30%。4、Barthel指数计分平均分是56.39±11.78。365名老年住院患者中,评为良(得分60分)的患者为87人(23.8%),评为中等(得分60～41分)的患者为198人(54.25%),评为差(得分≤40分)的患者为80人(23.8%)。5、随着年龄的增加,体重和BMI、白蛋白(ABL)呈现出下降趋势,而体脂肪百分百随着年龄的增加呈现上升趋势;随着老年住院患者BMI的增加,其体重、体脂含量、腰围、臀围、腰臀比、体脂肪百分比、血红蛋白、白蛋白、总胆固醇、甘油三酯、和低密度脂蛋白胆固醇的均值也随之升高,高密度脂蛋白胆固醇的均值随BMI的增加而降低。6、微型营养评价法(Mini Nutritional Assessment,MNA)结果显示,365名老年患者的MNA平均得分为24.87士 4.32,24名(6.6%)患者存在有营养不良,88名(24.1%)患者存在有营养不良风险(1 7≤MNA分值≤23.5),253名(69.3)营养正常(MNA分值≥24)。7、影响老年住院患者人营养状况的主要因素从大到小依次为:经济情况、慢性病患病数量、年龄、日常活动能力、抑郁程度得分、是否关注营养知识。其中与慢性病患病数量、年龄、抑郁程度得分呈负相关;而与经济情况、日常活动能力、是否关注营养知识呈正相关。研究结论1、依据MNA评分标准,365名住院患者中,24名(6.6%)患者存在有营养不良,88名(24.1%)患者存在有营养不良风险(17≤MNA分值≤23-5),253名(69.3)营养正常(MNA分值≥24)。2、影响老年住院患者人营养状况的主要因素从大到小依次为:经济情况、慢性病患病数量、年龄、日常活动能力、抑郁程度得分、是否关注营养知识。3、相关医疗机构应该对住院的老年患者的营养状况早期筛查和评估,以早期发现有营养不良风险的人群,并结合相关因素,制定具体的切实可行的三级预防方案。
[Abstract]:The main purpose of this study is to investigate the nutritional status of the elderly hospitalized patients in a class three grade a hospital in Guangzhou by cross-sectional study. The purpose of this study is to study the nutritional status of the elderly inpatients in Guangzhou, and to explore the related factors, so as to provide scientific basis for the intervention measures of the hospital medical care needles. At the same time, the elderly people have a healthy level of nutrition, strengthen their nutrition and health care, improve the nutritional and health status of the elderly, improve their quality of life, and achieve a healthy aging. The research method used a cross-sectional survey method to investigate all the three grade A hospitals in Guangzhou in the period of July, January 2016, -2016 years. The elderly hospitalized patients over 60 years of age, which were included in the inclusion and exclusion criteria, mainly used a structured questionnaire to collect the general situation of the subjects; the living habits and health status; the degree of depression; the daily activity (Activity of Daily Living, ADL) and the nutritional status of the elderly hospitalized patients; and through physical and laboratory tests. Obtain the related information of anthropometry and blood biochemical indexes. The original data are recorded, arranged and analyzed using SPSS 20 statistical software. The data are arranged and analyzed using frequency, the composition ratio, the mean number and the standard deviation are used to describe the survey results. The counting data is represented by the composition ratio; the continuity variables are normal test and Fang Chaqi. An independent sample test and an analysis of variance were used in the normal distribution. Mann Whitney U test and Kruskal-Wallis H test were used if the non conformity was used; the counting data were checked by chi square test. The factors influencing factors analysis first screened the variables with statistical significance on the nutritional status by single factor test, and then included multiple stepwise regression and Ordia L Logistic regression analysis and multiple regression analysis. Results 1. This study investigated 365 elderly hospitalized patients in a class three grade a hospital in Guangzhou, including 215 men (58.90%), 150 women (41.10%).2, high prevalence of chronic diseases, and 97.53% of the elderly hospitalized patients with chronic diseases, of which 18.36% of the elderly were old. The hospitalized patients had a chronic disease in the year, 48.77% of the elderly inpatients suffered from 2-3 chronic diseases and 30.41% of the elderly hospitalized patients suffered from 4 chronic diseases. The prevalence rate of hypertension in the survey population was 58.08%, the prevalence rate of diabetes was 50.14%.3, the average depression score was 3.65365 in the elderly inpatients and 88 had mild depression, about 24.. 11%; 23 people with severe depression accounted for about 6.30%.4, and the average score of the Barthel index was 56.39 + 11.78.365 in the elderly inpatients, and 87 (23.8%) was rated as good (score 60), and 198 (54.25%) in the middle (score 60~41) patients (54.25%), and the patients with a poor score (score < 40) were 80 (23.8%), with the increase of age. Weight and BMI, albumin (ABL) showed a downward trend, and body fat increased by 100 percent with age; with the increase of BMI in elderly patients, the weight, body fat content, waist circumference, hip circumference, waist hip ratio, body fat percentage, hemoglobin, white egg white, total cholesterol, triglyceride, and low density lipoprotein cholesterol The average value of HDL cholesterol decreased with the increase of BMI and.6. The Mini Nutritional Assessment (MNA) results showed that the average MNA score of 365 elderly patients was 24.87 n 4.32,24 names (6.6%) with malnutrition and 88 (24.1%) patients had a malnutrition risk (17 < < MNA score). < < 23.5), 253 (69.3) nutrition was normal (MNA score > 24).7. The main factors affecting the nutritional status of the elderly inpatients from large to small were economic situation, the number of chronic diseases, age, ability of daily activity, the score of depression, and whether they paid attention to the knowledge of nutrition. Conclusion 1, among 365 hospitalized patients, 24 (6.6%) had malnutrition, 88 (24.1%) had malnutrition (17 < < MNA score < 23-5), 253 (69.3) (69.3) nutrition (MNA score > 24).2, affecting the old, according to the MNA score standard. The main factors of nutritional status of inpatients in inpatients from large to small were economic situation, the number of chronic diseases, age, ability of daily activity, the score of depression,.3, and early screening and evaluation of the nutritional status of elderly patients in hospital, in order to find the risk of malnutrition early. Crowd, and combined with relevant factors, formulate specific and practical three level prevention program.

【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R151.41

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