多学科协作诊治指导下营养干预模式对老年心衰患者的影响

Effects of nutritional intervention model under guidance of MDT diagnosis and treatment on elderly patients with heart failure

中文关键词: 老年  MDT  心力衰竭  营养指标  血清蛋白  心功能

英文关键词: multidisciplinary team  heart failure  nutritional indicator  serum protein  cardiac function

中文摘要:

      目的 探究多学科协作诊治(MDT)模式下营养干预在老年心衰住院患者治疗中的应用,为治疗该病症提供方法.方法 选取2020 年4 月—2022 年4 月南京大学医学院附属鼓楼医院接诊的 118 例老年心衰住院患者作为研究对象,采用简单随机化法分为观察组和对照组,每组59 例.2 组均使用常规强心剂、利尿剂等.此外,对照组给予常规营养干预,观察组采用MDT模式下营养干预,2 组均持续干预3 个月.比较2 组干预前、干预3 个月时患者血清蛋白[血清前白蛋白(PA)、白蛋白(ALB)、血红蛋白(HGB)]水平、心功能[心排血量(CO)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、生活质量[心衰生活质量问卷(MLHFQ)]的变化.结果 干预 3 个月,2 组血清PA、ALB、HGB水平、CO值均显著高于同组干预前,观察组上述指标值均高于对照组(P均＜0.05);2 组MLHFQ评分均明显低于同组干预前,观察组MLHFQ评分显著低于对照组(P均＜0.05).结论 MDT模式下营养干预有利于预防老年心衰住院患者营养不良发生,提高患者生存质量,有利于患者预后,具有一定的临床应用价值.

英文摘要:

      Objective To explore the application of nutritional intervention under the guidance of multidisciplinary team(MDT)diagnosis and treatment model in elderly inpatients with heart failure,and provide a method for the treatment of this disease.Methods 118 elderly inpatients with heart failure admitted to Drum Tower Hospital Affiliated to Medical College of Nanjing University from April 2020 to April 2022 were selected as the study subjects.They were divided into observation group and control group by simple randomization method,with 59 cases in each group.Both groups were treated with conventional cardiac stimulants,diuretics,etc.In addition,the control group received routine nutritional intervention,while the observation group received nutritional intervention under the MDT model.Both groups received continuous intervention for 3 months.The changes in serum proteins[serum prealbumin(PA),albumin(ALB),hemoglobin(HGB)],cardiac function[cardiac out-put(CO),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]and quality of life[Minnesota Living with Heart Failure Questionnaire(MLHFQ)]were compared between the two groups before interven-tion and after 3 months of intervention.Results After 3 months of intervention,the levels of serum PA,ALB,HGB and CO of both groups were significantly higher than those of the same group,and the levels of above indicators of the observation group were higher than those of the control group(all P＜0.05);MLHFQ scores of both groups were significantly lower than those of the same group,and the score of the observation group was lower than those of the control group(all P＜0.05).Conclusion Nutritional intervention under MDT model is beneficial to prevent malnutrition in elderly inpatients with heart failure,improve their quality of life,and benefit their prognosis,and has certain clinical application value.