摘要
目的评估溃疡性结肠炎(UC)患者术前营养状况,为临床诊疗及护理提供指导。方法选择2010年2月—2012年8月我院经肠镜病理确诊并拟行手术治疗的UC患者80例,进行术前营养评估,内容包括血清学检查、营养代谢测定、膳食调查、食物不耐受检测,综合评定患者营养状况。结果 80例患者平均总蛋白(63±3)g/L、清蛋白(34±2)g/L、前清蛋白(16±4)g/L、转铁蛋白(203±18)g/L、纤维结合蛋白(172±14)mg/L、视黄醇结合蛋白(28±4)mg/L。前清蛋白水平低于参考值者52例(65.0%),清蛋白低于参考值者36例(45.0%)、视黄醇结合蛋白低于参考值者26例(32.5%)、总蛋白及转铁蛋白低于参考值者各20例(25.0%)、纤维结合蛋白低于参考值者6例(7.5%)。78例患者运用代谢车精确测定静息能量消耗值为(1 656±329)kcal/d,与Harris-Bene-dict公式计算的预计值(1 452±208)kcal/d比较,差异有统计学意义(t=2.41,P=0.037)。80例患者发病前后每日平均摄入蛋白质、脂肪、糖类及能量比较,差异均有统计学意义(P<0.05)。食物不耐受检测发现,64例(81.0%)患者存在轻度以上不耐受。不耐受食物依次为蛋清或蛋黄(46例)、牛奶(32例)、羊奶(32例)、鱼虾类(22例)、大米(16例)、小麦(16例)等。结论 UC患者术前营养状况较差,传统的常规检查不能完全满足对本病评估的需要,应包含营养代谢测定、膳食调查、食物不耐受检测,如患者需行术前营养治疗,供给能量应参考代谢车测得的静息能量消耗值。
Objective To investigate preoperative nutrition of ulcerative colitis （UC） patients in order to provide ref- erence for clinical diagnosis and treatment as well as nursing. Methods 80 UC patients confirmed by enteroscope and pathology from February 2010 to August 2012 were given evaluation on preoperative nutrition, which included serological examination, nu- trition metabolic level detection, dietary survey and food intolerance test to comprehensively analyze the patients＇ nutrition condi- tion. Results Among the 80 patients, the average total protein level was （ 63 ±3 ） g/L, albumin （ 34 ±2 ） g/L, prcalbumin （16±4） g/L, transferrin （203 ±18） g/L, fibronectin （172± 14） mg/L and retinol conjugated protein （28 ±4） mg/ L. Prealbumin in 52 cases （65.0%） , albumin in 36 cases （45.0%） , retinol conjugated protein in 26 cases （32.5%） , total protein in 20 cases （25.0%） , transferrin in 20 cases （25.0%） and fibronectin in 6 cases （7.5%） had lower level than refer- ential value. The resting energy expenditure was （ 1 656± 329 ） kcal/d by using metabolic car, and compared with the （ 1 452 ± 208 ） kcal/d calculated by Harris - Benedict formula, the difference was statistically significant （ t = 2.41, P = 0. 037） . The daily intake of protein, fat, carbohydrate and energy of the 80 patients before and after disease onset showed statistically signifi- cant differences （ P 〈 0. 05 ） . Food intolerance test showed that 64 cases （ 81.0% ） had intolerance above slight level. The intol- erance foods were egg white or egg yellow （46 cases） , milk （32 cases） , ewe＇s milk （32 cases） , fish and shrimp （22 ca- ses）, rice （ 16 cases） and wheat （ 16 cases） . Conclusion The preoperative nutrition of ulcerative colitis patients is poor and traditional routine tests were not enough for assessing this disease. Nutrition metabolic level detection, dietary survey and food in- tolerance test should be included. If nutritional support is needed before operation, the energy amount should be based on the rest- ing energy consumption tested by the metabolic car.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第6期667-669,共3页
Chinese General Practice
关键词
溃疡性结肠炎
营养状况
膳食
Ulcerative colitis
Nutritional status
Diet
作者简介
通讯作者：王春梅，300070天津市，天津医科大学护理学院；E-mail：cmwang8543@126．com
