慢性心力衰竭患者院内营养管理方案的构建及应用

Construction and clinical application evaluation of in-hospital nutrition management for patients with chronic heart failure

目的 :构建慢性心力衰竭患者院内营养管理方案并评价应用效果,以期为慢性心力衰竭患者全程化营养管理提供临床指导。方法 :采用便利抽样法,选取宁波市某三级甲等医院心血管内科收治的心力衰竭患者为研究对象,以2021年10月—12月收治的30例患者为对照组,给予常规治疗及营养管理;以2022年1月—4月收治的30例患者为实验组,采用多学科团队协作制定的慢性心力衰竭院内营养管理方案。比较两组患者微型营养评价简表(MNA-SF)、血清白蛋白及N末端B型利钠肽原(NT-pro-BNP)水平、住院时间、30 d再入院率。结果 :干预后,两组患者MNA-SF得分、血清白蛋白指标呈现先上升后下降趋势;实验组患者MNA-SF得分、血清白蛋白值、NT-pro-BNP值均优于对照组;实验组住院时间短于对照组;实验组30 d再入院率明显低于对照组,差异均有统计学意义(P<0.05)。结论:慢性心力衰竭院内营养管理方案能改善患者营养状况及心功能水平,缩短住院时间,降低30 d再入院率,可为临床慢性心力衰竭营养管理提供参考。

Objective:To establish an in-hospital nutrition management scheme for patients with chronic heart failure and evaluate the application effects,so as to guide the clinic work.Methods:Patients with chronic heart failure admitted to the cardiovascular department of a tertiary Grade A hospital in Ningbo were selected as the study participants.Thirty patients admitted from January to April 2022 were selected as the experimental group,and receive the in-hospital nutrition management program of chronic heart failure,which was developed by a multidisciplinary team.And thirty patients admitted from October to December 2021 were selected as the control group,who were given conventional treatment and nutrition.The Mini-nutritional Assessment Short Form(MNA-SF),albumin index,NT-pro-BNP,length of hospital stay and 30d readmission rate were compared between the two groups.Results:After intervention,MNA-SF scores and albumin value in the two groups increased first,and then decreased.The scores of MNA-SF,albumin value and NT-pro-BNP value in the experimental group were better than those in the control group.The duration of hospitalization in the experimental group was shorter than that in the control group.The 30d readmission rate of the experimental group was significantly lower than that of the control group,with statistical differences(P<0.05).Conclusion:In-hospital nutrition management program can improve the nutritional status and cardiac function of patients with chronic heart failure,shorten hospital stay and reduce 30d readmission rate,which can provide reference for clinical nutrition management of chronic heart failure.