老年慢性阻塞性肺疾病急性加重期营养不良干预与治疗的意义
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(1. 辽宁省金秋医院呼吸内科,沈阳 110016;2. 中国医科大学附属第四医院普外科,沈阳 110016)

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R563

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Malnutrition intervention and treatment for the elderly with acute exacerbation of chronic obstructive pulmonary disease
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(1. Department of Respiratory Diseases, Jinqiu Hospital of Liaoning Province, Shenyang 110016, China;2. Department of General Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110016, China)

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    摘要:

    目的 探讨营养不良干预与治疗在老年慢性阻塞性肺疾病急性加重期(AECOPD)患者中的应用价值。方法 入选辽宁省金秋医院呼吸内科2015年8月至2016 年8月收治的62例老年AECOPD合并营养不良或营养不良风险患者,按意愿分为营养治疗组及对照组,各31例,治疗8周。两组均给予常规抗感染及对症治疗;营养治疗组给予专业的营养咨询、营养教育及肠内营养支持,对照组给予普通饮食指导。比较两组治疗前后的体质量指数(BMI)、肱三头肌皮褶厚度(TSF)、上臂围长(MAC)及血清总蛋白(TP)、血清白蛋白(ALB)和血红蛋白(Hb)水平等。采用第1秒用力呼气容积(FEVl)、用力肺活量(FVC)和实测第1秒用力呼气容积与预计第1秒用力呼气容积的比值(实测FEV1/预计FEV1)评估患者治疗前后肺功能。采用圣乔治呼吸问卷(SGRQ)评分评估患者治疗前后生活质量。结果 治疗后,两组各项营养指标都有所改善(P<0.05),但营养治疗组升高幅度更大(P<0.05);两组肺功能指标FEVl、FVC及FEV1A/FEV1E均有改善(P<0.05),但营养治疗组改善程度更大,差异均有统计学意义(P<0.05);两组SGRQ总分均显著下降(P<0.01),但营养治疗组总分显著低于对照组,差异有统计学意义(P<0.01)。结论 及时合理地干预和治疗老年AECOPD患者的营养不良,能够明显改善患者的营养状况、恢复呼吸功能、提高生活质量。

    Abstract:

    Objective To investigate the values of intervention and treatment of malnutrition in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 62 elderly AECOPD patients combined with malnutrition or risk of malnutrition admitted in the Jinqiu Hospital of Liaoning Province from August 2015 to August 2016 were recruited in this study. According to their own willingness, they were divided into nutrition treatment group (n=31) and control group (n=31). Besides conventional anti-infection and symptomatic therapies to both groups for 8 weeks, the patients from the treatment group were given professional consultation, nutrition education and enteral nutrition support, while those of the control group only received common dietary guidance. The body mass index (BMI), triceps skin fold (TSF) thickness, mid-arm circumference (MAC), serum contents of total protein (TP), serum albumin (ALB) and hemoglobin (Hb) were measured before and after treatment. The patient’s pulmonary function was evaluated using forced expiratory volume in the fisrt second (FEV1), forced vital capacity, and ratio of actual FEV1 to expected FEV1 (FEV1A/FEV1E). St.George’s Respiratory Questionnaire (SGRQ) scores were used to evaluated the patient’s life quality. The above results were compared before and after treatment and between the 2 groups. Results After 8 weeks’ treatment, BMI, TSF, MAC, TP, ALB and Hb were all increased in both groups (P<0.05), and more significantly for those of the treatment group (P<0.05). The pulmonary function indices, including FEVl, FVC, FEV1A/FEV1E, were improved in the 2 groups (P<0.05), and more significantly in the treatment group (P<0.05). The SGRQ scores were decreased in the 2 groups (P<0.01), and more significantly in the treatment group (P<0.01). Conclusion Timely and reasonable intervention and treatment for malnutrition can obviously improve the nutritional status, restore respiratory function, and improve the quality of life in the elderly AECOPD patients.

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倪楠,林琳,薛运昕,杨沈佳,宁欣,郭天聪,边明艳,孟晓丹.老年慢性阻塞性肺疾病急性加重期营养不良干预与治疗的意义[J].中华老年多器官疾病杂志,2017,16(6):437~441

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  • 收稿日期:2017-02-15
  • 最后修改日期:2017-03-09
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  • 在线发布日期: 2017-06-27
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