尘肺病患者营养状况及营养干预对病情严重程度的影响

Effects of nutritional status and nutritional intervention on the severity of pneumoconiosis patients

目的调查尘肺病患者营养状况及营养干预对病情严重程度的影响。方法尘肺病患者68例,随机分为观察组和对照组,每组各34例。监测血清中白蛋白(ALB)、前白蛋白(PA)、上臂围(MAC)、肱三头肌皮褶厚度(TSF)、体质量指数(BMI)。两组均对症治疗,对照组给予常规护理,观察组在对照组基础上给予肠外营养干预。比较两组干预前后营养状态指标、病情严重程度和肺功能指标[第1秒用力呼气量(FEV1)、用力肺活量(FVC)、最大通气量(MVV)与用力呼气中段流速(MMEF)]。结果尘肺壹期BMI、TSF、MAC、ALB及TP明显高于尘肺贰期患者;尘肺贰期BMI、TSF、MAC、ALB及TP明显高于尘肺叁期患者,差异均有统计学意义(P<0.05)。轻度肺功能损伤患者BMI、TSF、MAC、ALB及TP明显高于中度肺功能损伤患者,中度肺功能损伤患者BMI、TSF、MAC、ALB及TP明显高于重度肺功能损伤患者,差异有统计学意义(P<0.05)。干预后,观察组BMI、TSF、MAC、ALB及TP均明显高于干预前;且明显高于对照组干预后,差异均有统计学意义(P<0.05)。干预后,观察组患者FVC、FEV1、MMEF及MVV明显高于干预前;且明显高于对照组,差异均有统计学意义(P<0.05)。结论尘肺患者普遍存在营养状况下降,这与病情严重程度有关,合理营养干预有助于改善尘肺患者的全身营养状况及肺功能。

Objective To investigate the effects of nutritional status and nutritional intervention on the severity of pneumoconiosis.Methods 68pneumoconiosis patients were randomly divided into observation group and control group,with 34cases in each group.Serum albumin(ALB),anterior albumin(PA),upper arm circumference(MAC),triceps cutaneous fold thickness(TSF)and body mass index(BMI)were monitored.Both groups were symptomatic treatment,the control group to give routine nursing,observation group in the control group on the basis of parenteral nutrition intervention.Nutritional status indicators,disease severity and pulmonary function indicators before and after intervention were compared between the two groups[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),Maximal voluntary ventilation(MVV)and forced expiratory midcourse flow rate(MMEF)].Results BMI,TSF,MAC,ALB and TP in pneumoconiosis stage I were significantly higher than those in pneumoconiosis stage ii.BMI,TSF,MAC,ALB and TP in pneumoconiosis ii were significantly higher than those in pneumoconiosis iii,with statistically significant differences(P<0.05).BMI,TSF,MAC,ALB and TP of patients with mild lung function injury were significantly higher than those of patients with moderate lung function injury,and BMI,TSF,MAC,ALB and TP of patients with moderate lung function injury were significantly higher than those of patients with severe lung function injury,the difference was statistically significant(P<0.05).After intervention,BMI,TSF,MAC,ALB and TP in the observation group were significantly higher than before intervention.The difference was statistically significant(P<0.05).After intervention,FVC,FEV1,MMEF and MVV in the observation group were significantly higher than before intervention.The difference was statistically significant(P<0.05).Conclusions Nutritional status of pneumoconiosis patients generally is lower,and is related to the severity of the disease.Reasonable nutritional intervention is helpful to improve the general nutritional status and pulmonary function of pneumoconiosis patients.