| Objective: To analyze the therapeutic effect of professional nutritional support on acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients with nutritional risk and malnutrition,and further professional nutritional support on AECOPD with nutritional risk and malnutrition patients can provide reference for the application.Methods: From January to December in 2015, Data of 1020 patients with AECOPD hospitalized in department of respiratory medicine in the Affiliated Hospital of Chengdu University, were retrospectively collected according following diagnostic criteria: Global Initiative for Chronic Obstructive Lung Disease 2013,(GOLD 2013) was used as AECOPD diagnostic criteria, nutritional risk screening 2002 total score ≥ 3 points was used as nutritional risk criteria and body mass index(BMI)<18.5 was used as malnutrition criteria. Among 1020 patients, by excluding patients with metabolic diseases, consciousness et.al who might have apparent impact to the research, 54 patients with nutritional department consultation in 3 days after hospitalized were divided into the professional nutritional support group by checking NRS 2002 scores, discharge diagnosis and consultation notes, and other 54 patients obtained by randomly drawing from other AECOPD patients with nutritional risk and malnutrition patients as the voluntarily nutritional support group(the control group). The proportion was calculated by NRS≥3 patients divided all patients with AECOPD and by the professional nutritional support patients divided by the exclusion criteria after AECOPD nutritional risk with malnutrition patients.General conditions of patients, clinical symptoms and nutrition-related laboratory indicators between the two groups were compared before and after treatment.Results: 1 Proportion of nutritional risk in hospitalized AECOPD was 43.3%;The proportion of patients with nutritional risk and malnutrition of AECOPD who received professional nutritional support was 34.2%.2 Baseline horizontal analysis: Patients were divided into two groups with good baseline consistency. 3 Analysis intervention effect(change of laboratory test index): Comparing with relevant indicators betweenadmission and discharge, white blood cell count and Pa CO2 were decreased for all patients of the two groups(P<0.05), while Pa O2 was increased(P<0.01);In the professional nutritional support group, lymphocyte count, albumin and prealbumin were increased in discharge(P<0.01), there was no statistical significance to compare the difference of hemoglobin(P>0.05); In the control group, there was no statistical significance to compare the difference of lymphocyte count, hemoglobin, albumin and prealbumin(P>0.05). Comparing with the indicators of discharge patients, lymphocyte count, albumin and prealbumin increased in professional nutritional support group compared with those of the control group(P <0.05); there was no statistical significance to compare the difference of white blood cell count, hemoglobin, Pa CO2 and Pa O2 between the two groups(P>0.05).4Analysis intervention effect(change of clinical symptoms): Comparing with relevant indicators between admission and discharge such symptoms as cough scores, scores of autonomous expectoration capability, dyspnea scores and m MRC scores between two groups of patients had a dramatic decline(P <0.01). Comparing with the indicators of discharge patients, professional nutritional support group had a larger decline in terms of cough scores and scores of autonomous expectoration capability than the control group(P <0.05); there was no statistical significance to compare the difference of dyspnea scores and m MRC scores between the two groups(P>0.05).5Professional nutritional support group had a shorter hospital stay than the control group(P <0.05).Conclusions: 1.Nutritional risk coupled with malnutrition is ubiquitous in AECOPD, but few of them receive professional nutritional.2.Professional nutritional support can effectively improve patients’ symptoms such as a series of nutritional indexes(eg:albumin prealbumin and lymphocyte count) and clinical symptoms(eg:cough,autonomous expectoration capability), and the length of hospital stay. |
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