老年重症肺炎患者营养水平现状和康复干预效果观察

Nutritional status of elderly patients with severe pneumonia and effects of rehabilitation intervention

中文关键词: 老年, 重症肺炎, 营养水平, 免疫功能, 康复阶梯图

英文关键词: elderly  severe pneumonia  nutrient level  immune function  rehabilitation ladder diagram

中文摘要:

      目的 观察老年重症肺炎患者营养风险的发生情况,并应用康复阶梯图对有营养风险患者进行干预,以期为临床患者预后的改善提供循证依据.方法 选取2019年5月-2023年12月在新疆维吾尔自治区人民医院接受治疗的120例老年重症肺炎患者,均应用营养风险筛查2002量表(NRS2002)对自身营养风险情况进行筛查,接着采用随机数字表法将有营养风险患者分为观察组与对照组.观察组采取康复阶梯图干预,对照组行常规营养干预.记录并比较2组干预前后患者血清营养指标、免疫指标和肺功能指标的变化情况.结果 120例老年重症肺炎患者均完成NRS2002量表筛查,结果显示,62例患者有营养风险,占比51.67％(62/120),58例患者无营养风险,占比48.33％(58/120).无营养风险组平均年龄、NRS2002评分、APACHE Ⅱ评分低于有营养风险组,血清TRF、ALB、TP、PA水平高于有营养风险组,差异均有统计学意义(P＜0.05).干预后,2组患者血清TRF、ALB、TP和PA水平均高于同组干预前,且观察组上述指标水平均高于对照组(P＜0.05).干预后,2组患者血清IgM、IgG、IgA、CD3+、CD4+及CD4+/CD8+值均高于同组干预前,且观察组上述指标值均高于对照组(P＜0.05).干预后,2组R水平低于干预前,Cdyn水平高于干预前,且观察组R水平低于对照组,Cdyn水平高于对照组,差异均有统计学意义(P＜0.05).结论 老年重症肺炎患者营养风险发生率较高,应用康复阶梯图可提升有营养风险患者的营养状态与免疫功能,改善患者肺功能.

英文摘要:

      Objective To explore the nutritional risk in elderly patients with severe pneumonia,intervene in the patients with nutritional risk based on rehabilitation ladder diagram,and provide evidence-based evidence for improving the prognosis of clinical patients.Methods 120 elderly patients with severe pneumonia who were treated in People's Hospital of Xinjiang Uygur Autonomous Region from May 2019 to December 2023 were selected.The Nutritional Risk Screening Scale 2002(NRS2002)was used to screen their nutritional risk status.The patients with nutritional risk were divided into observation group and control group by random number table method.The control group received routine nutritional intervention,and the observation group received intervention based on rehabilitation ladder diagram.The changes of serum nutritional indexes,im-mune indexes and pulmonary function indexes before and after intervention were recorded and compared between the two groups.Results All 120 elderly patients with severe pneumonia completed NRS2002 scale screening.The results showed that 62 patients had malnutrition,accounting for 51.67％(62/120),and 58 ones had no malnutrition,accounting for 48.33％(58/120).The mean age,NRS2002 score and APACHE Ⅱ score of the non-malnutrition group were lower than those of the malnutrition group,and the levels of serum TRF,ALB,TP and PA were higher than those of the malnutrition group(P＜0.05).After intervention,the levels of serum TRF,ALB,TP and PA of both groups were higher than those of the same group before intervention,and the observation group was higher than the control group(P＜0.05).The levels of serum IgM,IgG,IgA,CD3+,CD4+and CD4+/CD8+of both groups were higher than those of the same group before intervention,and the ob-servation group was higher than the control group(P＜0.05).The R levels of both groups were lower than those of the same group before intervention,and the Cdyn levels were higher than those of the same group before intervention,and the R level of the observation group was lower than that of the control group,and the Cdyn level was higher than that of the control group(P＜0.05).Conclusion The incidence of nutritional risk in elderly patients with severe pneumonia is high.The application of rehabilitation ladder diagram can improve the nutritional status and immune function of patients with nutritional risk,and im-prove their lung function.