Chai Li Tay, Nor Haslinda Ishak, Mohd Fairuz Ali, Nor Shahrina Mohd Zawawi, Noor Azah Abd Aziz
{"title":"长期卒中门诊中一名营养不良的卒中后男性,患有多种疾病和肌肉疏松症:病例报告。","authors":"Chai Li Tay, Nor Haslinda Ishak, Mohd Fairuz Ali, Nor Shahrina Mohd Zawawi, Noor Azah Abd Aziz","doi":"10.51866/cr.281","DOIUrl":null,"url":null,"abstract":"<p><p>A 78-year-old post-stroke man with multiple comorbidities who was activity of daily living- dependent developed aspiration pneumonia associated with nasogastric tube (NGT) blockage. He presented with malnutrition and risk of sarcopenia with hypoalbuminaemia, small calf circumference (CC), low body mass index and small mid upper arm circumference. He showed symptoms of moderate-to-severe vascular dementia with behavioural psychological stress disorder, resulting in carer stress. Psychoeducation among the carers and referral to a neuro-psychiatrist were ensued after outpatient-based team meeting discussion. Herein, we highlight the importance of screening for sarcopenia and nutritional status in post-stroke patients with the use of the CC and serum albumin level as well as the involvement of a multidisciplinary team in the primary care setting to improve patient outcomes. Percutaneous endoscopic gastrostomy tubes are more suitable than NGTs for post-stroke patients who require enteral feeding to improve the nutritional status.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150325/pdf/MFP-18-12.pdf","citationCount":"0","resultStr":"{\"title\":\"A malnourished post-stroke man with multi-morbidity and sarcopenia risk in a long-term stroke clinic: A case report.\",\"authors\":\"Chai Li Tay, Nor Haslinda Ishak, Mohd Fairuz Ali, Nor Shahrina Mohd Zawawi, Noor Azah Abd Aziz\",\"doi\":\"10.51866/cr.281\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A 78-year-old post-stroke man with multiple comorbidities who was activity of daily living- dependent developed aspiration pneumonia associated with nasogastric tube (NGT) blockage. He presented with malnutrition and risk of sarcopenia with hypoalbuminaemia, small calf circumference (CC), low body mass index and small mid upper arm circumference. He showed symptoms of moderate-to-severe vascular dementia with behavioural psychological stress disorder, resulting in carer stress. Psychoeducation among the carers and referral to a neuro-psychiatrist were ensued after outpatient-based team meeting discussion. Herein, we highlight the importance of screening for sarcopenia and nutritional status in post-stroke patients with the use of the CC and serum albumin level as well as the involvement of a multidisciplinary team in the primary care setting to improve patient outcomes. Percutaneous endoscopic gastrostomy tubes are more suitable than NGTs for post-stroke patients who require enteral feeding to improve the nutritional status.</p>\",\"PeriodicalId\":40017,\"journal\":{\"name\":\"Malaysian Family Physician\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-03-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150325/pdf/MFP-18-12.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Malaysian Family Physician\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.51866/cr.281\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Nursing\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Malaysian Family Physician","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.51866/cr.281","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Nursing","Score":null,"Total":0}
引用次数: 0
摘要
一名 78 岁的中风后男子患有多种并发症,日常生活依赖他人,因鼻胃管(NGT)堵塞而引发吸入性肺炎。他出现营养不良和肌少症风险,伴有低白蛋白血症、小腿围(CC)小、体重指数低和中上臂围小。他出现了中重度血管性痴呆的症状,伴有行为心理应激障碍,造成了照顾者的压力。在门诊团队会议讨论后,对照护者进行了心理教育,并将其转诊至神经精神科医生。在此,我们强调了利用 CC 和血清白蛋白水平筛查中风后患者肌肉疏松症和营养状况的重要性,以及在初级护理环境中让多学科团队参与进来以改善患者预后的重要性。对于需要肠内喂养以改善营养状况的中风后患者,经皮内窥镜胃造瘘管比NGT更合适。
A malnourished post-stroke man with multi-morbidity and sarcopenia risk in a long-term stroke clinic: A case report.
A 78-year-old post-stroke man with multiple comorbidities who was activity of daily living- dependent developed aspiration pneumonia associated with nasogastric tube (NGT) blockage. He presented with malnutrition and risk of sarcopenia with hypoalbuminaemia, small calf circumference (CC), low body mass index and small mid upper arm circumference. He showed symptoms of moderate-to-severe vascular dementia with behavioural psychological stress disorder, resulting in carer stress. Psychoeducation among the carers and referral to a neuro-psychiatrist were ensued after outpatient-based team meeting discussion. Herein, we highlight the importance of screening for sarcopenia and nutritional status in post-stroke patients with the use of the CC and serum albumin level as well as the involvement of a multidisciplinary team in the primary care setting to improve patient outcomes. Percutaneous endoscopic gastrostomy tubes are more suitable than NGTs for post-stroke patients who require enteral feeding to improve the nutritional status.
期刊介绍:
The Malaysian Family Physician is the official journal of the Academy of Family Physicians of Malaysia. It is published three times a year. Circulation: The journal is distributed free of charge to all members of the Academy of Family Physicians of Malaysia. Complimentary copies are also sent to other organizations that are members of the World Organization of Family Doctors (WONCA).