NRS 2002在老年COPD合并吞咽障碍患者中的应用价值

Application Value of Nutritional Risk Screening 2002 in ElderlyCOPD Patients with Dysphagia

目的应用营养风险筛查2002(nutritional risk screening 2002,NRS 2002)量表评估老年慢性阻塞性肺疾病(Chronic obstructive lung disease,COPD)合并吞咽障碍患者住院时的营养风险发生率,并探究NRS 2002在临床中的应用价值。方法选取2021年11月至2022年10月在云南省第三人民医院全科医学科收治的老年COPD合并吞咽障碍患者124例,根据评分结果将患者分为NRS≥3组(n=69例)和NRS<3组(n=55例)。比较2组的一般资料及营养相关生化指标(总蛋白、白蛋白和前白蛋白),并进行相关性分析。结果老年COPD合并吞咽障碍患者营养风险发生率为55.6%,存在营养风险的患者中80岁以上占84.0%(P<0.05),营养风险评分≥3分组的总蛋白、白蛋白、前白蛋白水平和BMI值均低于<3分组(P<0.05)。采用Spearman相关分析显示,营养风险评分与年龄、住院时间、住院费用呈正相关(P<0.05),与营养学相关指标(总蛋白、白蛋白、前白蛋白、BMI)水平呈负相关(P<0.05)。单因素方差分析结果显示,NRS 2002评分、总蛋白、白蛋白、BMI的均值在不同吞咽障碍等级的患者中,总体分布差异具有统计学意义(P<0.05),各组间前白蛋白水平差异均无统计学意义(P﹥0.05)。结论老年COPD合并吞咽障碍患者营养风险发生率高(55.6%),NRS 2002可作为老年COPD合并吞咽障碍患者的早期营养风险筛查,早期识别患者的营养风险,采取积极干预措施,预防老年COPD患者吞咽障碍的发生。

Objective To evaluate the incidence of nutritional risk in hospitalized elderly patients with chronic obstructive pulmonary disease complicated with dysphagia with the Nutritional Risk Screening 2002 scale,and to explore the clinical application value of NRS 2002.Methods A total of 124 elderly patients with COPD complicated with swallowing disorder admitted to the Department of General Medicine of the Third People’s Hospital of Yunnan Province from November 2021 to October 2022 were selected.The patients were divided into NRS≥3 group(n=69 cases)and NRS<3 group(n=55 cases).The general data and nutrition-related biochemical indexes(total protein,albumin,and prealbumin)of the two groups were compared,and a correlation analysis was performed.Results The incidence of nutritional risk in elderly COPD patients with dysphagia was 55.6%.Among the patients with nutritional risk,84.0%were over 80 years old(P<0.05).The levels of total protein,albumin,prealbumin and BMI of nutritional risk score≥3 group were lower than those of group with<3(P<0.05).Spearman correlation analysis showed that the nutritional risk score was positively correlated with age,length of stay,and hospitalization cost(P<0.05),and negatively correlated with the levels of nutrition-related indicators(total protein,albumin,prealbumin and BMI)(P<0.05).The results of one-way ANOVA showed that there were statistically significant differences(P<0.05)in the mean values of NRS 2002 score,total protein,albumin,and BMI among patients with different levels of swallowing disorders.However,there was no statistically significant difference(P>0.05)in the levels of pre-albumin among the groups.Conclusion Elderly COPD patients with swallowing disorders have a high incidence of nutritional risk(55.6%).NRS 2002 can be used as an early nutritional risk screening tool for elderly COPD patients with swallowing disorders.Early identification of nutritional risk in patients and taking proactive intervention measures can prevent the occurrence of swallowing disorders in elderly COPD patients.