对吞咽功能障碍老年人进行营养干预研究

目的通过对吞咽功能障碍老年人进行营养干预,以观察病人营养不良的改善及吞咽功能的恢复。方法选择65～80岁吞咽功能障碍病人,洼田饮水试验≥3级者,随机分为对照组和试验组。对照组按照膳食医嘱给予流质、半流质、软食等,试验组则给予全糊状饮食,进行膳食干预。结果 60例病人微型营养评价精法(Mini-Nutritional Assessment Short Form,MNA-SF)营养不良为78. 3%,全面营养评价法(Body Composition Assessment,BCA)营养不良为83. 8%。干预前,2组病人的营养状况评价差异无统计学意义(P=0. 234,P=0. 360)。干预后,2组病人的营养状况差异具有统计学意义(P=0. 047,P=0. 016)。经过30 d干预,除体质量指数(body mass index,BMI)外,试验组的血红蛋白(hemoglobin,HB)、白蛋白(albumin,ALB)水平均高于对照组(P=0. 034,P=0. 042)。2组吞咽障碍程度比较,试验组低于对照组,差异具有统计学意义(P=0. 037)。结论对吞咽功能障碍老年人实施营养干预,可以改善病人的营养不良,维持其吞咽功能,提高生活质量。

Study on nutritional intervention for elderly people with dysphagia

Objective To observe the improvement of malnutrition and the recovery of swallowing function by performing nutritional intervention in the elderly with dysphagia.Methods The patients aged 65-80 years old with dysphagia graded 3 or higher by Watian drinking water test were selected.They were randomly divided into the control group and the experimental group.The control group was given fluid,semi-liquid or soft food according to the dietary advice,and the experimental group was given a paste diet for dietary intervention.Results Sixty patients were evaluated by Mini-Nutritional Assessment Short Form(MNA-SF)and Total Composition Assessment(BCA),with a malnutrition rate of 78.3%or 83.8%respectively.Before the intervention,there was no difference in the nutritional status between the two groups(P=0.234,P=0.360),and after the intervention,there was statistically significant difference between the two groups(P=0.047,P=0.016).After 30 days of intervention,the levels of hemoglobin(HB)and albumin(ALB)of the control group were lower than those of the experimental group(P=0.034,P=0.042).The degree of dysphagia in the experimental group was lower than that in the control group(P=0.037).Conclusions Nutritional interventions for elderly people with dysphagia can improve the malnutrition,maintain their swallowing function,and improve their quality of life.