老年慢性阻塞性肺病稳定期患者家庭肠内营养治疗疗效观察

Observation on the curative effect of family enteral nutrition in elderly patients with chronic obstructive pulmonary disease in stable stage

目的探讨家庭肠内营养支持在合并营养不良的老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者中的应用效果。方法选取2016年4月至2018年4月在内蒙古医科大学第三附属医院治疗并出院的合并营养不良的老年COPD稳定期患者155例,出院后给予常规饮食治疗79例(对照组),常规饮食+肠内营养混悬液(能全力,500 kcal/瓶)支持治疗76例(观察组)。随访1个月后观察两组患者的营养状况[包括BMI、血清白蛋白(ALB)、总蛋白(TP)、血红蛋白(Hb)]、肺功能状况[包括用力肺活量(forced vital capacity,FVC)、第1秒钟用力呼气容积(forced expiratory volume,FEV1)、FEV1/FVC、FEV1占预计值的百分比(FEV1%)]、运动耐量(采用6 min步行试验评估)及生活质量情况(采用圣乔治呼吸问卷评估)。两组间比较采用t检验。结果与对照组患者比较,观察组患者BMI及ALB水平明显升高(t=10.465、6.189,P<0.05),TP及Hb水平无明显变化(t=1.310、1.302,P>0.05),FVC、FEV1、FEV1/FVC、FEV1%均明显增加(t=11.999、19.654、13.418、16.924,P<0.05),生活质量症状评分、活动评分、影响评分及总分均明显下降(t=15.303、6.773、23.600、14.766,P<0.05),6MWT明显增加(t=111.962,P<0.05)。结论家庭肠内营养支持可改善COPD稳定期合并营养不良的老年患者的营养状态、肺功能、活动耐量以及患者的生活质量。

Objective To explore the effect of home enteral nutrition support in the elderly patients with chronic obstructive pulmonary disease(COPD)in stable stage with malnutrition.Methods From April 2016 to April 2018,155 patients with COPD in stable stage with malnutrition who were treated and discharged from the Third Affiliated Hospital of Inner Mongolia Medical University were selected.After discharge,79 patients(group A)were given conventional diet,and 76 patients(group B)were given conventional diet plus enteral nutrition suspension to support the treatment.One month later,they were observed the body mass index(BMI),serum albumin(ALB),total protein(TP),hemoglobin(HB),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC,FEV1%of the predicted value(FEV1%),exercise tolerance and quality of life.Results Compared with the group A,the BMI and ALB levels of group B were significantly higher(t=10.465,6.189,P<0.05),the TP and Hb levels were not significantly changed(t=1.310,1.302,P>0.05),the FVC,FEV1,FEV1/FVC,FEV1%were significantly increased(t=11.999,19.654,13.418,16.924,P<0.05),the quality of life symptom score,activity score,impact score and total score were significantly decreased(t=15.303,6.773,23.600,14.766,P<0.05),6 MWT increased significantly(t=111.962,P<0.05).Conclusion Family enteral nutrition can improve the nutritional status,lung function,activity tolerance and quality of life of elderly patients with COPD in stable stage with malnutrition.