代谢车在老年慢性阻塞性肺疾病患者营养治疗中的应用

Application of metabolic vehicle in nutritional treatment of elderly patients with chronic obstructive pulmonary disease

目的:探讨运用代谢车测定老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease ,COPD)患者静息能量消耗(resting energy expenditure,REE)或通过Harris—Benedict(HB)公式计算REE,指导老年COPD患者进行营养治疗对各项营养指标及临床预后的影响。方法:选取2015-01~2018-06在我院干部科、呼吸科住院的老年COPD患者82例,随机分为观察组( n =41)和对照组( n =41)。观察组通过代谢车测定REE并进行营养治疗,对照组采用传统HB公式计算REE并进行营养治疗。记录两组平均干预15 d后患者的营养指标及肺部感染发生率、呼吸衰竭发生率、住院时间,并进行统计学比较。结果:观察组干预后体质量指数(body mass index,BMI)、上臂围、小腿围、前白蛋白、转铁蛋白、总胆固醇、甘油三酯及住院时间均明显优于对照组,差异有统计学意义( P <0.05),两组其他营养指标及呼吸衰竭发生率、肺部感染发生率比较无明显统计学差异( P >0.05)。结论:代谢车能够更加准确合理地指导老年COPD患者进行规范营养治疗,应在临床广泛推广。

Objective: To explore the influence of the nutritional indexes and clinical prognosis of the elderly patients with chronic obstructive pulmonary disease(COPD) after receiving nutritional treatment based on the resting energy expenditure(REE) which was measured by metabolic vehicle or calculated by Harris-Benedict(HB) formula. Methods: Eighty-two elderly patients with COPD who were hospitalized in the department of cadre′s ward and respiratory in our hospital from January 2015 to June 2018 were selected,and were randomly divided into observation group and control group,41 cases in each group.The observation group was given nutrition treatment by the metabolic vehicle,the control group was given nutrition treatment by the traditional HB formula.The nutritional indexes and the infection incidence, the incidence of respiratory failure,length of hospital stay after 15 days′ intervention in the two groups were recorded and compared. Results: After the intervention,the body mass index(BMI),upper arm circumference,calf circumference,prealbumin,transferrin,total cholesterol,total triglyceride and hospitalization time of the observation group were significantly better than those of the control group,with statistically significant differences ( P <0.05).There was no significant difference in the other nutritional indexes,incidence rate of respiratory failure and incidence rate of infection between the two groups ( P >0.05). Conclusion: Metabolic vehicle is more accurately and rationally in guiding elderly COPD patients to accept standard nutrition treatment, which should be widely used in clinical practice.