社区脑卒中后患者营养现状的流行病学调查

目的 调查上海市虹口区社区医院住院的卒中后患者吞咽障碍、低白蛋白血症和营养不良的检出率以及进食情况.方法 采用横断面研究,以438例在社区医院住院的卒中后患者为研究对象,记录其人口学特征、洼田饮水试验评估结果、营养学指标(包括人体测量学指标和生化指标)和进食情况.结果 438例卒中后患者吞咽障碍、低白蛋白血症和营养不良的检出率分别为18.6%、42.7%和52.7%;376例患者经口进食,61例鼻饲肠内喂养,1例经皮内窥镜胃造瘘术.其中376例经口进食患者中32%进食量恢复正常,60%进食量为正常状态的一半以上,8%为正常状态的一半以下;62例肠内营养患者中46例能量需要量未按照"肠内肠外营养临床指南(2006版)"推荐的标准实施.结论 社区医院住院的卒中后患者中仍有相当大比例的患者存在吞咽障碍,低白蛋白血症及营养不良的检出率高;患者进食缺乏统一管理,饮食内容随意无序,进食缺乏监控;临床医生应关注卒中后患者的营养现状.

An epidemiologic survey on nutritional status among post-stroke patients at community hospitals

Objective To investigate, the detection rate of dysphagia, hypoalbuminemia, malnutri- tion, and eating condition among post--stroke patients at community hospitals in Hongkou District of Shanghai. Methods A cross sectional study was carried out on 438 post-- stroke patients who were admitted at community hospitals, information was gathered including demographic characteristics, the resuits of the assessment about water swallow test , nutrition assessment indices（anthropometry indices and nutritional biochemical indices） and eating situation. Results The detection rate of dysphagia, hypoalbu- minemia and malnutrition were 18.6% ,42.7%and 52.7% respectively. There were 376 patients with o- ral feeding, 61 patients with nasal feeding and 1 patient with percutaneous endoscopic gastrostomy. The 32% of 376 patients with oral feeding returned to normal food intaking, 60% to more than half of the normal state, 8% to less than half the normal state. Energy was not provided enough according to the requirement of ＂Enteral and parenteral nutrition clinical guidelines （2006 edition）＂ for 46 patients among 62 patients with enteral nutrition. Conclusions There were high detection rate of dysphagia, hypoalbu- minemia and malnutrition among post-- stroke patients at community hospitals. The lack of standard management on eating supervision among patients was lacking, food content was disorganized. Clinician should pay close attention to the nutrition status in post--stroke patients.