终末期肝病食谱APP改善肝硬化患者并发营养不良及衰弱的研究

Study on APP for end-stage liver disease recipe to improve liver cirrhosis complicated with malnutrition and frailty

目的探讨终末期肝病食谱应用程序(end-stage liver disease recipe application,ESLDR APP)对肝硬化患者并发营养不良及衰弱的治疗效果。方法选取2022年3月至2022年8月在内蒙古科技大学包头医学院第二附属医院住院的60例肝硬化并发营养不良及衰弱患者,通过ESLDR APP为上述患者提供3个周期的治疗(每30 d为1个治疗周期),于每个周期结束到院复查,以排除依从性较差的患者,并检查有无食物过敏或出现其他并发症。比较患者使用ESLDR APP治疗3个周期前后的BMI、上臂围(arm circumference,AC)、三头肌皮褶厚度(triceps skin-fold thickness,TSF)及上臂肌围(arm muscle circumference,AMC)的差异,总蛋白、白蛋白、胆碱酯酶及胆汁酸的差异,优势手握力的差异,衰弱表型评估(frailty phenotype,FP)结果的差异。并于3个治疗周期结束后通过调查问卷的形式收集上述患者对ESLDR APP的评价。结果最终共入组53例患者,男28例,女25例。患者使用ESLDR APP治疗3个周期前后BMI、AC、TSF、AMC、总蛋白、白蛋白及胆碱酯酶水平均显著升高,胆汁酸水平、FP结果显著降低,差异均有统计学意义(P均<0.05);优势手握力有升高趋势但差异无统计学意义(P>0.05);说明达到了一定程度的干预效果。通过调查问卷方式收集53例肝硬化患者对ESLDR APP的评价,37例(69.81%)认为本APP对改善营养不良及衰弱非常有效;10例(18.87%)认为一般有效;6例(11.32%)认为无效。结论ESLDR APP通过为患者制定科学营养的食谱,达到了改善肝硬化并发营养不良及衰弱的目的,提升了蛋白水平及营养状况,使患者受益。

Objective To investigate the therapeutic effect of end-stage liver disease recipe application(ESLDR APP)on liver cirrhosis with malnutrition and frailty.Methods Sixty liver cirrhosis patients with malnutrition and asthenia hospitalized in the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from Mar.2022 to Aug.2022 were selected.The above patients were treated with ESLDR APP for three cycles(one treatment cycle every 30 days).At the end of each cycle,they were reexamined in the hospital to exclude patients with poor compliance,and checked for food allergy or other complications.To compare the differences of BMI,arm circumference(AC),triceps skin-fold thickness(TSF)and arm muscle circumference(AMC);the differences of total protein,albumin,cholinesterase and bile acid;the difference of dominant hand grip strength and the differences in the results of the frailty phenotype(FP)of patients before and after 3 cycles of treatment with ESLDR APP.The evaluation of the above patients on ESLDR APP was collected by questionnaire after 3 treatment cycles.Results Finally,53 patients were successfully enrolled,including 28 males and 25 females.The patients′BMI,AC,TSF,AMC,total protein,albumin and cholinesterase were significantly increased(P<0.05);the levels of bile acid and FP score were significantly decreased(P<0.05);the dominant hand grip strength of patients had an upward trend,but the difference was not statistically significant(P>0.05),before and after 3 cycles of ESLDR APP treatment.It indicating that a certain degree of intervention effect was achieved.The evaluation of ESLDR APP was collected from 53 liver cirrhosis patients through questionnaires.A total of 37 patients(69.81%)believed that this APP was very effective in improving malnutrition and asthenia;10 cases(18.87%)believed that this APP was generally effective in improving malnutrition and asthenia;6 cases(11.32%)believed that this APP was ineffective in improving malnutrition and asthenia.Conclusion ESLDR APP has achieved the goal of improving liver cirrhosis with malnutrition and asthenia by formulating scientific nutrition recipes for patients,and has improved the protein level and nutritional status,benefiting patients.