专业随访指导在克罗恩病家庭肠内营养中的应用

Effect of professional follow-up care in patients with Crohn's disease receiving home enteral nutrition

目的:观察克罗恩(Crohn's disease,CD)家庭肠内营养患者给予3 mo专业随访指导后治疗效果状况.方法:选择2013-04/2014-03在上海第十人民医院消化内科住院确诊的缓解期C D患者52例,出院后给予整蛋白肠内营养制剂,营养专业小组专业随访指导3 mo,该组病例作为专业随访组(研究组).回顾分析2012-01/2012-12同院同科室住院确诊的缓解期CD患者61例,出院后给予相同的肠内营养制剂,此为回顾组(对照组).比较两组患者出院后家庭营养支持的临床症状、营养和血液指标的变化.结果:专业随访组出院后不同时间段体质量指数、上臂围、肱三头肌皮皱厚度、钾、钠、钙、白蛋白、血红蛋白差异性具有统计学意义(P<0.01),表明CD患者通过家庭肠内营养治疗随着时间的延长,并通过随访指导的干预,各指标明显好转,病情逐渐恢复.两组患者3 mo家庭肠内营养治疗后,营养与血液指标差异有统计学意义(P<0.01),表明CD患者通过营养小组专业随访干预的有效性.结论:营养支持小组专业随访指导CD患者进行家庭肠内营养支持,对营养和血液指标的恢复有明显效果,促进治疗,提高患者生活品质.

AIM： To assess the effect of 3 mo of professional follow-up care in patients with Crohn’s disease（CD） receiving home enteral nutrition. METHODS： Fifty-two patients with CD in remission who were hospitalized from April 2013 to March 2014 at Shanghai Tenth People’s Hospital, given enteral nutrient solution after discharge and received professional follow-up guidance for 3 mo were included in a study group. Sixtyone patients with CD in remission who werehospitalized from January 2012 to December2012 at the same hospital, given the same enteral nutrient solution after discharge, but did not receive the professional follow-up guidance were included in a control group. The improvement of clinical symptoms and changes in nutritional and blood indexes were compared between the two groups. RESULTS： Body mass index, upper arm circumference, triceps skinfold thickness, potassium, sodium, calcium, albumin, and hemoglobin differed significantly among different time points after discharge in the study group（P 〈 0.01）. After 3 mo of home enteral nutrition, nutritional and blood indexes were statistically significant between the two groups（P 〈0.01）. CONCLUSION： Professional follow-up care has a significant effect on the restoration of nutritional and blood indexes and can improve therapeutic effects and patients’ quality of life.