多学科团队协作模式的营养干预对慢性阻塞性肺病急性加重期患者营养状态的影响

Nutrition management under multi-disciplinary team in nutritional status of patients with acuteexacerbation of chronic obstructive pulmonary disease

目的了解多学科团队协作模式的筛查-评估-计划-治疗营养干预对慢性阻塞性肺病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者营养状态及住院时间的影响。方法采用便利抽样的方法,选取2019年6月至2020年6月在本院呼吸与危重症医学科收治的AECOPD患者为研究对象。根据入院时间先后次序,将2019年6月至12月入院治疗的AECOPD患者52例设为对照组,采用常规营养干预模式;将2020年1月至6月入院治疗的AECOPD患者52例设为试验组,实施多学科团队协作模式的筛查-评估-计划-治疗营养干预,比较入院时和出院时两组患者总蛋白、白蛋白及血红蛋白值的差异及住院时间的差异。结果两组患者入院时总蛋白、白蛋白及血红蛋白值的比较,差异无统计学意义(均P>0.05)。两组患者出院时总蛋白值、白蛋白值比较,差异有统计学意义(均P<0.05),而血红蛋白值比较,差异无统计学意义(P>0.05)。试验组患者住院时间(11.8±3.7)d,对照组(13.9±3.9)d,两组比较,差异有统计学意义(t=-2.897,P=0.005)。结论多学科团队协作模式的筛查-评估-计划-治疗营养干预可改善AECOPD患者营养状态,促进疾病康复,从而缩短住院时间。

Objective To investigate the effect of multi-disciplinary team (MDT) nutrition management based on screening-assessment-planning-treatment model on nutritional status and hospital stay of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Between June and December 2019, 52 patients with AECOPD in the department of respiratory and critical care medicine of Sichuan Provincial People’s Hospital were enrolled as the control group and were given standard enteral nutrition or food according to their preference. Between January and June 2020, 52 patients with AECOPD in the department were enrolled as the trial group and were managed with the MDT nutrition management based on screening-assessment-planning-treatment model. The two groups were compared with in terms of blood biochemical indexes, including total protein, albumin and haemoglobin, at admission and discharge and during hospitalisation. Results There was no significant difference in total protein, albumin and haemoglobin between the two groups on admission (P>0.05). There were significant differences in total protein and albumin between the two groups at discharge (P<0.05), but no significant difference in haemoglobin (P>0.05). Of the hospital stay, the experimental group had significantly longer time of stay than that the control group (11.8±3.7 days vs. 13.9±3.9 days;t=-2.897, P=0.005). Conclusion MDT nutrition management based on screening-assessment-planning-treatment model improves the nutritional status of AECOPD patients, promotes recovery, and shortens the time of hospital stay.