营养支持及护理干预在老年COPD患者中的应用

Effects of nutritional support and nursing intervention in elderly patients with chronic obstructive pulmonary disease

目的 探讨营养支持及护理干预对老年COPD 患者呼吸困难评分、BMI、呼吸功能、生活质量等指标的影响。方法 采用单纯随机抽样法选取宁波市第一医院2014 年1 月—2016 年1 月收治的老年COPD急性发作患者118 例作为研究对象。按照随机数表法将其分为对照组和观察组。观察组59 例患者，给予营养支持及护理干预，对照组59 例患者，给予常规护理。比较两组患者呼吸困难评分、BMI、 6 min步行距离（6MWT）、呼吸功能指标，采用圣乔治呼吸问卷（SGRQ）评价患者生活质量。结果 干预前，两组患者呼吸困难评分、BMI、6MWT、呼吸功能指标以及SGRQ 得分差异均无统计学意义（P ＞ 0.05）；干预后观察组呼吸困难评分低于对照组，差异有统计学意义（P＜ 0.05）；观察组BMI、6MWT 高于对照组，差异有统计学意义（P＜ 0.05）；观察组呼吸功能指标均优于对照组，差异均有统计学意义（P ＜ 0.01）；观察组患者症状得分、活动度得分、影响度得分和SGRQ 总得分均低于对照组，差异有统计学意义（P ＜ 0.05）。结论 营养支持及护理干预对降低老年COPD 患者呼吸困难评分、SGRQ 评分，提高 BMI、6MWT 等均有作用，能够改善老年COPD 患者的临床疗效和生活质量，值得推广和应用。

Objective To explore the effects of nutritional support and nursing intervention on the score of dyspnea, body mass index （BMI）, respiratory function and quality of life in elderly patients with chronic obstructive pulmonary disease （COPD）. Methods A total of 118 cases of elderly patients with COPD who were hospitalized in Ningbo First Hospital from January 2014 to January 2016 were selected by simple random sampling method and divided into observation group and control group by random number table method, with 59 cases in each group. The observation group received nutritional support and nursing intervention, while the control group was given routine nursing intervention. The score of dyspnea, BMI, the distance of 6-minute walking test （6MWT） and respiratory function were compared between the two groups. The St George＇s Respiratory Questionnaire （SGRQ） was applied to evaluate the quality of life of the patients. Results There was no significant difference in the score of dyspnea, BMI, 6MWT, respiratory function and the score of SGRQ between the two groups before intervention （P〉 0.05）. After intervention, the score of dyspnea of the observation group was lower than that of the control group （P 〈 0.05） ; the BMI and 6MWT of the observation group were higher than those of the control group （P 〉 0.05） ; the respiratory function of the observation group was better than that of the control group （P 〈 0.01）; the symptom score, activity score, degree of influence score and SGRQ total score of the observation group were significantly lower than those of the control group （P 〈 0.05）, and all the differences were statistically significant. Conclusions The nutritional support and nursing intervention have a major impact on dyspnea score, BMI, SGRQ score, and 6MWT in elderly patients with COPD. It can significantly improve the clinical efficacy and quality of life of patients, and is worthy of clinical promotion.