整蛋白型肠内营养对老年肝硬化患者营养指标、NRS2002评分、肝功能及并发症的影响

目的 探讨整蛋白型肠内营养对老年肝硬化患者营养指标、NRS2002评分、肝功能及并发症的影响.方法 选取2015年3月至2019年3月文昌市人民医院收治的148例老年肝硬化患者为研究对象,采用随机数字表法分为观察组和对照组,每组74例.对照组进行常规饮食,观察组在常规饮食的基础上加用整蛋白型肠内营养剂,两组连续干预6个...

Effects of whole protein enteral nutrition on nutritional indexes,NRS 2002 score,liver function and complications on elderly patients with liver cirrhosis

Objective To investigate the effects of whole protein enteral nutrition on nutritional indexes,NRS 2002,liver function and complications on elderly patients with liver cirrhosis.Methods A total of 148 elderly patients with liver cirrhosis admitted in Wenchang City People’s Hospital from March 2015 to March 2019 were selected and divided into observation group and control group according to random number table method,74 cases in each group.Patients in control group carried on the routine diet,while patients in observation group took the whole protein type enteral nutrition agent on the basis of control group,the patients were continuously intervened for 6 months.The body mass indes(BMI),albumin(ALB),prealbumin(PA),prothrombin activity(PTA),total lymohocyte count(TLC),alanine aminotransferase(ALT),total bilirubin(TBil)and plasma prothrombin time(PT)levels of patients in two groups before and after treatment were compared.The nutritional risk of patients in two groups were screened by NRS2002 score method.The complications of gastrointestinal bleeding,hepatorenal syndrome,hepatic encephalopathy and secondary infection were recorded.Results Before treatment,there were no significant differences in BMI(19.07±2.80)kg/m²vs(19.15±2.56)kg/m²],ALB(32.78±2.81)g/L vs(31.94±2.84)g/L],PA(98.06±18.84)mg/L vs(99.74±19.60)mg/L],PTA(54.82±19.54)%vs(53.79±18.68)%]and TLC(1.21±0.92)×109/L vs(1.23±1.02)×10⁹/L]levels of patients in observation group and control group(all P>0.05).After treatment,BMI(22.14±2.52)kg/m²vs(20.97±2.37)kg/m²],ALB(36.25±2.66)g/L vs(34.89±2.88)g/L],PA(10⁹.17±17.64)mg/L vs(101.46±16.51)mg/L]and PTA(66.30±20.30)%vs(56.14±19.28)%]levels of patients in observation group were significantly higher than those in control group,the differences were statistically significant(all P<0.05),there was no statistically significant difference in TLC(1.11±0.94)×10⁹/L vs(1.21±0.82)×10⁹/L]level between the two groups(t=0.690,P=0.491).Before treatment,there was no significant difference in the proportion of malnutrition risk between the two groups2.70%(2/74)vs 5.41%(4/74);χ²=0.174,P=0.677].After treatment,the proportion of malnutrition risk in observation group was significantly lower than that in control group40.54%(30/74)vs 94.59%(70/74);χ²=49.333,P<0.001].After treatment,the proportion of patients with malnutrition risk in both groups were significantly higher than those before treatment,and the differences were statistically significant(χ²=31.259,117.730,all P<0.001).Before treatment,there were no significant differences in ALT(77.15±20.54)U/L vs(69.58±19.97)U/L],TBil(50.70±15.25)μmol/L vs(49.26±12.60)μmol/L]and PT(19.13±2.65)s vs(19.76±2.36)s]levels of patients in observation group and control group(all P>0.05).After treatment,ALT level of patients in observation group was significantly higher than that of control group(39.83±11.32)U/L vs(34.51±12.17)U/L],while TBil(22.95±8.53)μmol/L vs(33.85±11.93)μmol/L]and PT(14.76±1.64)s vs(18.87±1.59)s]levels were significantly lower than those of control group,the differences were statistically significant(all P<0.05).After treatment,the levels of ALT,TBil and PT of patients in two groups were significantly lower than those before treatment,the differences were statistically significant(all P<0.05).During the treatment period,the incidence of hepatic encephalopathy4.05%(3/74)vs 18.92%(14/74)]and secondary infection8.11%(6/74)vs 25.68%(19/74)]of patients in observation group were significantly lower than those of control group,the differences were statistically significant(χ²=6.646,8.134;P=0.010,0.004).There were no significant differences in the incidence of gastrointestinal bleeding6.76%(5/74)vs 10.81%(8/74)]and hepatorenal syndrome2.70%(2/74)vs 6.76%(5/74)]between the two groups(P=0.384,0.245).Conclusions Whole protein enteral nutrition can improve the malnutrition and liver function of elderly patients with liver cirrhosis,reduce the rate of nutritional risk and effectively prevent the occurrence of complications,which is worthy of clinical promotion.