慢性阻塞性肺疾病患者的营养评估及营养支持现况调查

摘要

目的:调查病房慢性阻塞性肺病患者的营养状况、临床开展营养支持的情况及疗效,探讨医学营养治疗对营养不良的改善作用.方法:采用NRS2002量表,结合营养相关指标(BMI、小腿围、ALB、膳食营养素摄入量等)进行营养不良的诊断,通过医院信息管理系统及患者护理记录,详细记录患者营养支持途径及营养摄入量,分析营养支持途径、能量及营养素分配比例对患者营养状况的影响.结果:共调查了197名患者,入院时72.59％的患者存在营养风险,49.75％的患者诊断为营养不良,营养不良的患者中仅23.47％的患者能量摄入合理,仅17.35％的患者营养素比例合理,采用经口天然食物、ONS、EN、PN的比例分别为79.59％、5.10％、3.06％、12.24％.出院前41.62％的患者存在营养风险,22.84％的患者诊断为营养不良,营养不良的患者中82.22％的患者能量摄入合理,100％的患者营养素比例合理,采用经口天然食物、ONS、EN、PN的比例分别为46.67％、31.11％、22.00％、0％.营养不良患者与营养正常患者在营养支持途径的选择和营养合理摄入方面存在差异,均为P ＜0.05.结论:慢性阻塞性肺疾病患者的营养状况较差,ONS、EN等营养支持途径可保证能量及营养素的合理供给,慢阻肺患者的营养支持应重视多种途径的联合应用.%[Objective] To investigate the nutritional status,nutritional support and efficacy of chronic obstructive pulmonary disease (COPD) patients in the ward,and to explore the effect of medical nutrition treatment on malnutrition.[Method] Using the NRS2002 scale,combined with nutrition related indicators (BMI,calf circumference,ALB,dietary intake,etc.) for diagnosis of malnutrition,through the hospital information management system and patient care records,detailed records of patients with nutritional support ways and nutrition al intake,analyzed nutritional support ways,energy and nutrients affect the allocation of the proportion of the nutritional status of patients.[Result] There were 197 patients on admission and 72.59％ of the patients with nutritional risk,49.75％ patients diagnosed as malnutrition,reasonable intake of only 23.47％ of the patients malnutrition in patients with reasonable nutrition only 17.35％ in proportion,the export of natural food,ONS,EN,PN ratio was 79.59％,5.10％,3.06％,12.24％.Before discharge,41.62％ of the patients with nutritional risk,22.84％ of patients diagnosed with malnutrition,82.22％ malnourished patients with reasonable calorie,reasonable nutrition were 100％ in proportion,with natural food,ONS,EN,PN ratio was 46.67％,31.11％,22％,0％.There were differences in nutritional support pathway and nutritional intake between malnourished patients and normal nutrition patients,all were P ＜ 0.05.[Conclusion] The patients with chronic obstructive pulmonary disease with poor nutritional status,ONS,EN and other nutrition support way can ensure the reasonable supply of energy and nutrients,nutritional support in patients with COPD should pay attention to the combination of different ways.