The Effect Of Individualized Nutritional Support Treatment On Malnutrition In Patients With Alcoholic Liver Diseases

[Objective]To understand the individual nutritional status of patients with alcoholic hepatitis patients and explore the effect of individualized nutritional intervention to correct alcoholic hepatitis malnutrition,in order to reduce malnutrition of liver damage and the incidence of complications,and the formation of individualized nutrition intervention for patients with alcoholic hepatitis in clinical application.[Methods]The peoples From October 2015 to December 2016 in Rugao City People’s Hospital of Gastroenterology of alcoholic hepatitis inpatients were chose.first using nutritional risk screening(NRS-2002)table to determine the nutritional risk patients,and BMI index assessment of malnutrition in patients with alcoholic hepatitis patients included 60 cases of standard,random numbers randomly,using the envelope methods the patients were randomly divided into observation group and control group with 30 cases in each group,the control group received routine treatment and drinking,nutrition guidance,observation group based on routine treatment of liver alcohol,with individualized nutrition intervention,1 months for a course of treatment,a total of 3 courses.Before the intervention and 3 months after the effective index of patients were assessed,including anthropometric indices(body mass index,triceps skinfold thickness,arm muscle circumference)and laboratory indexes(serum albumin,liver function),and the safety indicators(blood routine,urine routine).[Results]1 Effectiveness index1.1 AnthroPometric indices(1)BMI:①Patients in the two groups before the intervention of body mass index(BMI),the difference was not statistically significant(P>0.05);BMI of two groups after the intervention,the difference was statistically significant(P<0.05).② The two groups of patients before and after intervention own control,the patients in the observation group BMI was statistically significant difference(P<0.05),the difference of BMI patients in the control group no statistical significance(P>0.05).(2)The triceps skinfold thickness:①Two groups of patients before intervention,triceps skinfold thickness(TSF),the difference was not statistically significant(P>0.05).②There was significant difference in the triceps skinfold thickness(TSF)between the observation group and the control group(P<0.05)in the two groups before and after the intervention.(3)The upper arm muscle circumference:①Before the intervention two groups of patients with upper arm muscle circumference(AMC),the difference was not statistically significant(P>0.05),comparable.②There were significant differences in AMC between the observation group and the control group(P<0.05).1.2 Experimental index(1)Serum albumin:① Two groups of patients with serum albumin level before intervention,the difference was not statistically significant(P>0.05),comparable;3 months after the intervention,patients in two groups were compared between groups,there were statistically significant differences in the level of serum albumin(P<0.05).②3 months after the intervention,the observation group before and after the control,with statistical significance the difference of serum albumin level(P<0.05);control group before and after comparison,no statistically significant difference between the level of serum albumin(P>0.05).(2)Liver function:①Before intervention,two groups of patients with liver function(ALT,AST,AST/ALT ratio and GGT)showed no significant difference(P>0.05),comparable.②3 months after the intervention,two groups of patients with liver function(ALT,AST,AST/ALT ratio)the difference was statistically significant(P<0.05);observation group and the control group were self control,liver function index(ALT,AST,with the ratio of AST/ALT and GGT)showed significant differences(P<0.05).1.3 Incidence of malnutrition:The incidence of malnutrition was 17.2%and 51.9%in the observation group and the control group after 3 months of intervention,respectively,and the incidence of malnutrition was 100%and the difference was not statistically significant(P>0.05)The difference was statistically significant(P<0.05).2 Safety indexThere was no significant difference between the two groups before and after the intervention of blood routine and urine routine indicators(P>0.05).[Conclusion]1 Individualized nutritional interventions can improve the body mass index and serum albumin levels of alcoholic hepatitis patients,and the effectiveness of conventional nutritional guidance is not obvious.2 Individualized nutritional intervention with conventional nutritional guidance two intervention modes of triceps skinfold,upper arm muscle circumference and the improvement of liver function has the remarkable effect,and have a significantly lower incidence of malnutrition,and the former is superior to the latter.3 Nutrition intervention in patients with alcoholic hepatitis,should follow the principle of"they intend the nursing",considering the patients’ height,weight,the intensity of labor and other individual difference is the different demand for energy and nutrients.