脑卒中患者营养不良风险评估及对康复护理的对策研究

[目的]分析脑卒中患者营养风险影响因素,并探讨康复护理对策的制定.[方法]随机选取2018年7月—2020年7月丽水市中心医院神经外科收治的急性出血性脑卒中患者152例,根据微型营养评估(MNA)量表评分结果,将患者分为正常组、风险组和不良组.采用单因素分析与相关性分析方法,分析患者可能存在的营养风险影响因素,并针对影...

Influencing factors of nutritional risks and rehabilitation nursing countermeasures in stroke patients

[Objective]To explore the nutritional risk influencing factors in stroke patients,and to discuss the formulation of rehabilitation nursing countermeasures.[Methods]We randomly selected 152 patients with acute hemorrhagic stroke admitted to our hospital from July 2018 to July 2020. Based on the results of the mini nutritional assessment(MNA)score,the patients were divided into normal group(49 cases),risk group(53 cases),and bad group(50 cases). Single factor analysis and correlation analysis were used to analyze the nutritional risk factors,and the countermeasures for the influencing factors were discussed.[Results]Univariate analysis showed that stroke time,mechanical ventilation,swallowing dysfunction,ADL score,upper arm muscle circumference,serum albumin,and total lymphocyte count in risk and bad groups were different from the normal group. In comparison,the proportion of patients with mechanical ventilation and swallowing dysfunction was higher,and ADL score,upper arm muscle circumference,serum albumin level and total lymphocyte count were lower(P<0.05). The Spearman rank correlation analysis showed that the factors with differences in the univariate analysis also showed correlation(P<0.05). Among them,the positive correlation factors included the duration of stroke,receiving mechanical ventilation,swallowing dysfunction,NIHSS score,negatively related factors included ADL score,serum levels of albumin,transferrin,and hemoglobin. Multivariate Logistic regression analysis showed that stroke time(OR=1.739,P<0.001)and swallowing dysfunction(OR=3.966,P=0.008)were independent risk factors for malnutrition. ADL score(OR=0.687,P<0.001),upper arm muscle circumference(OR=0.770,P=0.012),serum albumin level(OR=0.870,P=0.003)were independent protective factors for malnutrition.[Conclusion]The nutritional status in stroke patients is not optimistic. Most patients have swallowing disorders,motor dysfunction,and poor self-care ability. At the same time,the body protein content in patients has decreased significantly. The clinical work is needed to deal with the patients’ swallowing function recovery together with the treatment of nerve damage.