| 林卫,苏俐莉,李冬梅,何俊睿,康宝仁.医学营养治疗对脑卒中患者营养水平与泌尿系结石高危因素及预后的影响[J].中国临床保健杂志,2023,26(5):659-665. |
| 医学营养治疗对脑卒中患者营养水平与泌尿系结石高危因素及预后的影响 |
| Effects of medical nutrition therapy on the nutritional level,high-risk indicators of urinary calculi and prognosis in patients with stroke |
| 投稿时间：2023-01-09 |
| DOI：10.3969/J.issn.1672-6790.2023.05.018 |
| 中文关键词: 卒中 结石 营养支持 危险因素 预后 |
| 英文关键词: Stroke Calculi Nutritional support Risk factors Prognosis 〖FL |
| 基金项目:广西壮族自治区科技计划项目(桂科AD20238075);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201329) |
| 作者 | 单位 | E-mail | | 林卫 | 广西壮族自治区江滨医院,老年康复科,营养科,南宁 530021 | 41077057@qq.com | | 苏俐莉 | 广西壮族自治区江滨医院,老年康复科,营养科,南宁 530021 | 41077057@qq.com | | 李冬梅 | 广西壮族自治区江滨医院,老年康复科,营养科,南宁 530021 | 41077057@qq.com | | 何俊睿 | 广西壮族自治区江滨医院,老年康复科,营养科,南宁 530021 | 41077057@qq.com | | 康宝仁 | 广西壮族自治区江滨医院,老年康复科,营养科,南宁 530021 | 41077057@qq.com |
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| 中文摘要: |
| 目的 研究医学营养治疗(MNT)对脑卒中患者营养水平和泌尿系结石高危指标及预后的影响。方法 将2020年7月至2021年6月广西壮族自治区江滨医院收治的150例脑卒中患者根据就诊顺序编号并采用简单随机化法均分为常规组、院内组和全程组各50例,3组均针对脑卒中进行个体化治疗,在此基础上院内组采用MNT干预28 d,全程组采用MNT干预1年,比较3组干预前后营养状态、泌尿系结石高危指标和代谢相关生化指标变化。结果 3组治疗1个月、3个月、12个月时,低密度脂蛋白胆固醇(LDL-C)水平明显降低(P<0.05),且全程组治疗12个月时,血浆LDL-C水平低于常规组和院内组,差异有统计学意义(P<0.05)；常规组和院内组治疗12个月时,24 h尿液钙和草酸含量明显升高(P<0.05),全程组治疗12个月时,24 h尿液尿酸含量均明显降低(P<0.05),且全程组治疗12个月时,24 h尿液钙、草酸以及尿酸含量均低于常规组和院内组,差异有统计学意义(P<0.05)；3组治疗后1年内脑卒中复发率、病死率、营养不良率和泌尿系结石发生率,差异无统计学意义(P>0.05),全程组超重/肥胖患者占比低于常规组和院内组,差异有统计学意义(P<0.05)。结论 脑卒中患者采用MNT进行全程干预有利于减少钙和草酸等泌尿系结石高危物质摄入,在维持良好营养状态的同时改善脂质代谢,从而减少超重或肥胖发生,且长期干预效果更为显著。 |
| 英文摘要: |
| Objective To study the effects of medical nutrition therapy (MNT) on the nutritional level,high-risk indicators of urinary calculi and prognosis in patients with stroke.Methods One hundred fifty patients with stroke in the hospital between July 2020 and June 2021 were numbered by admission sequence and were divided into routine group,nosocomial group and whole-course group according to the simple randomization method,with 50 cases in each group.All the three groups received individualized treatment for stroke.On this basis,the nosocomial group received MNT intervention for 28 days,and the whole-course group was given MNT intervention for 1 year.The nutritional status,high-risk indicators of urinary calculi and metabolism-related biochemical indicators were compared among the three groups.Results The plasma low-density lipoprotein cholesterol (LDL-C) level in the three group was significantly reduced at 1 month,3 months and 12 months of treatment (P<0.05),and the plasma LDL-C level in the whole-course group was lower than that in the routine group and the nosocomial group (P<0.05).The levels of 24 h urine calcium and oxalic acid in the routine group and the nosocomial group were significantly increased at 12 months of treatment (P<0.05),and the level of 24 h urine uric acid in the whole-course group was significantly decreased after 12 months of treatment (P<0.05),and the levels of 24 h urine calcium,oxalic acid and uric acid at 12 months of treatment in the whole-course group were lower than those in the routine group and the nosocomial group (P<0.05).There were no significant differences in the incidence rates of stroke recurrence,mortality,malnutrition and urinary calculi within 1 year after treatment among the three groups (P>0.05).The proportion of patients with overweight/obesity in the whole-course group was lower than that in the routine group and the nosocomial group (P<0.05).Conclusions MNT for whole-course intervention in patients with stroke is beneficial to reducing the intake of high-risk substances such as calcium and oxalic acid in urinary calculi and improving the lipid metabolism while maintaining the good nutritional status,thereby reducing the occurrence of overweight or obesity.And its long-term intervention effect is more significant. |
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