目的 观察对老年痴呆合并营养不良患者进行微型营养评价精法(MNA-SF)支持与康复结合的治疗的营养状况变化. 方法 前瞻性研究,入选2014年7月至2017年7月在我院老年内科住院的老年痴呆合并营养不良的患者50例,数字抽签法分为单纯肠内营养支持(对照组,25例)与肠内营养结合康复治疗(观察组,25例),将治疗前后的人体测量指标(体质指数、上臂围、小腿围、三头肌皮褶厚度)与生化指标(血红蛋白、血清总胆固醇、三酰甘油、血清白蛋白、总淋巴细胞计数)进行组内与组间对比. 结果 两组患者治疗前的体质指数、上臂围、小腿围、三头肌皮褶厚度比较均无统计学意义(P>0.05),治疗30 d后,两组患者的上述指标组内比较差异有统计学意义(P<0.01),观察组的数据优于对照组,组间比较具有统计学意义(P<0.01);两组患者治疗前的生化指标对比差异无统计学意义(P>0.05),治疗30 d后,三酰甘油与血清总胆固醇的水平组内与组间的比较差异均无统计学意义(P>0.05),血红蛋白(组内t=2.548,组间t=2.645)、血清白蛋白(组内t=2.864,组间t=2.843)、总淋巴细胞计数(组内t=2.976,组间t=2.967)组内与组间比较差异有统计学意义(P<0.01). 结论 肠内营养结合康复治疗对老年痴呆患者的营养状况改善具有客观的积极的影响.
Objective To investigate changes in nutritional status in senile dementia patients with malnutrition treated with enteral nutrition combined with rehabilitation therapy evaluated by using the Mini Nutritional Assessment-Short Form(MNA-SF).Methods Fifty hospitalized patients with senile dementia and malnutrition at the internal medicine department of our hospital from July 2014 to July 2017 were enrolled and further divided into an enteral nutrition group(a control group,n =25)and an enteral nutrition combined with rehabilitation therapy group(an observation group,n=25).Anthropometric parameters including body mass index,biceps circumference,calf circumference,triceps skin-fold thickness,and blood biochemical parameters including hemoglobin,total cholesterol,triacylglycerol,albumin,lymphocyte count before and after treatment were compared between the groups.Results Anthropometric parameters such as body mass index,biceps circumference,calf circumference and triceps skin-fold thickness had no significant difference between the two groups before treatment (P > 0.05),while after 30 days of treatment,anthropometric parameters saw improvement in both groups compared with those before treatment,and the improvement was greater in the observation group than in the control group(P <0.01).Blood biochemical parameters had no significant difference between the two groups before treatment(P>0.05).After 30 days of treatment,levels of total cholesterol and triacylglycerol had no significant difference compared with those before treatment or between the two groups(P >0.05),while levels of hemoglobin,albumin and lymphocyte count improved compared with those before treatment (t =2.645,2.843,2.967,respectively,P <0.01),and had significant differences between the groups (t =2.548,2.864,2.976,respectively,P<0.01).Conclusions Enteral nutrition combined with rehabilitation therapy has a measurable,positive influence on nutritional status in senile dementia patients with malnutrition.