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长期住院患者的营养状况及物理治疗相关风险的管理

Nutritional status and management of risks due to physical therapy in patients hospitalized for long periods.

作者信息

Kimura Daisuke, Murata Minako, Kimura Yuko, Nunotani Masahiro, Hayashi Yoshitaka, Abe Kazuo

机构信息

Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare: 288 Matsushima, Kurashiki City 701-0193, Okayama, Japan.

Nissyoukai Ikunoaiwa Hospital, Japan.

出版信息

J Phys Ther Sci. 2017 Nov;29(11):1910-1913. doi: 10.1589/jpts.29.1910. Epub 2017 Nov 24.

Abstract

[Purpose] This study aimed to understand the nutritional status of patients hospitalized for long periods and the risk of physical therapy (PT) for such patients. [Subjects and Methods] Participants were selected from patients who were hospitalized at a designated medical long-term care sanatorium. The participants were divided into 5 groups (A-E) depending on their mode of energy intake and ambulatory ability during PT. The serum albumin level, energy intake, total daily energy expenditure, and total daily energy expenditure per session of PT (EEPT) were evaluated for each group. [Results] Protein-energy malnutrition was observed in 69.6% of the participants. No significant association was identified between the serum albumin level and body mass index. Energy intake was significantly higher in Groups D and E, whose energy intake was via ingestion, than in Groups A and B, whose intake was via tube feeding. EEPT was highest in patients of Group E who had gait independence different from the ability of those in groups A-D. [Conclusion] The actual energy intake is lower with tube feeding than with ingestion. Risk management and energy intake should be revisited in elderly patients who have been hospitalized for long periods and subsequently obtain gait independence.

摘要

[目的]本研究旨在了解长期住院患者的营养状况以及此类患者接受物理治疗(PT)的风险。[对象与方法]研究对象选自某指定医疗长期护理疗养院的住院患者。根据患者在PT期间的能量摄入方式和行走能力,将参与者分为5组(A - E)。对每组患者的血清白蛋白水平、能量摄入、每日总能量消耗以及每次PT的每日总能量消耗(EEPT)进行评估。[结果]69.6%的参与者存在蛋白质 - 能量营养不良。血清白蛋白水平与体重指数之间未发现显著关联。通过摄入方式获取能量的D组和E组的能量摄入量显著高于通过管饲方式获取能量的A组和B组。E组患者的EEPT最高,其步态独立性与A - D组患者不同。[结论]管饲的实际能量摄入量低于摄入方式。对于长期住院后获得步态独立性的老年患者,应重新审视风险管理和能量摄入情况。

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本文引用的文献

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The Issue of Nutrition in an Aging Society.
J Nutr Sci Vitaminol (Tokyo). 2015;61 Suppl:S176-7. doi: 10.3177/jnsv.61.S176.

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