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瓣膜置换术患者营养风险筛查及护理对策

Nutrition risk screening for patients of cardiac valves replacement and nursing countermeasure

摘要:

目的 应用欧洲营养风险筛查评分(NRS2002)评估行瓣膜置换手术患者的术前营养状况,分析评估效果并提出对应的护理措施.方法 依照NRS2002对拟体外循环下行瓣膜置换手术的患者226例进行营养风险评分,筛查出具有营养风险的患者88例,随机将这88例患者分成干预组和对照组各44例,分别对2组患者实施不同的护理措施,比较2组患者临床结局的不同.结果 行体外循环下瓣膜置换手术的226例患者术前营养风险评分≥3分者88例,<3分者138例,术前营养风险的得分与心功能分级成正相关.对于存在营养风险的患者,经过随机对照实验发现,干预组与对照组患者在住院时间、术后机械通气时间及总并发症发生率方面比较差异均有统计学意义.结论 应用NRS2002分析瓣膜置换手术患者的术前营养状况是客观有效的,对伴有营养风险的患者进行术前护理干预可有效改善预后,并为进一步研究营养支持与营养风险患者的临床结局之间的关系提供了理论依据.

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Objective To evaluate the preoperative nutritional status of the patients which were preparing for cardiac valves replacement using nutrition risk screening 2002 (NRS2002),and analyze the evaluation effect and bring forward the corresponding nursing interventions.Methods 226 patients who would carry out cardiac valves replacement in the context of extracorporeal circulation were evaluated by NRS2002 preoperatively.88 patients had nutrition risk.Those elective 88 patients were randomly assigned into the experimental group and the control group,each had 44 cases.Then different nursing measures were implemented in each group and the clinical outcome was contrasted in the two groups.Results In the patients who were preparing for cardiac valves replacement,88 cases had preoperative nutrition risk score ≥3 points and 138 cases < 3 points.Preoperative nutrition risk score had positive correlation with heart function grade.Difference of the experimental group and the control group in length of stay,length of mechanical ventilation after surgery and incidence rate of general complications had statistical significance.Conclusions It is effective to analyze the preoperative nutritional status of the patients with cardiac valves replacement by NRS2002.It may improve prognosis effectively by providing preoperative nursing interventions for patients with nutrition risk.Besides,it provides theoretical basis for further studying the relation between nutrition support and clinical outcome of patients with nutrition risk.

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