基于归因理论的综合营养护理干预方案对老年慢性阻塞性肺疾病患者营养状况的影响

车丽萍; 唐琦; 蒋燕红; 周黛娜; 胡玲琴; 冯莉; 俞建洪

doi:10.16766/j.cnki.issn.1674-4152.003695

基于归因理论的综合营养护理干预方案对老年慢性阻塞性肺疾病患者营养状况的影响

doi: 10.16766/j.cnki.issn.1674-4152.003695

1.
绍兴文理学院附属医院老年医学科, 浙江绍兴 312000
2.
绍兴文理学院附属医院呼吸与危重症医学科, 浙江绍兴 312000
3.
绍兴文理学院附属医院营养科, 浙江绍兴 312000

基金项目:

浙江省医药卫生科技项目 2022KY1314

详细信息

通讯作者:
唐琦, E-mail：964768243@qq.com

中图分类号: R563 R473.59
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- 被引次数: 0
出版历程
- 收稿日期: 2024-03-20

Effect of comprehensive nutrition nursing intervention program based on attribution theory on nutritional status of elderly patients with chronic obstructive pulmonary disease

1.
Department of Geriatric Medicine, Affiliated Hospital of Shaoxing University of Arts and Sciences, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的营养状况与老年慢性阻塞性肺疾病(COPD)患者预后关系密切，本文旨在探讨归因理论的综合营养干预在老年COPD患者中的应用效果。方法采用随机数字表法将2021年8月—2023年8月就诊于绍兴文理学院附属医院的108例老年COPD患者分为对照组(54例，传统营养干预)和试验组(54例，基于归因理论的综合营养干预)，最终2组各51例入组。比较2组营养状况、血清营养学指标、免疫功能及营养不良发生率。结果护理6个月试验组BMI(22.09±4.67 vs.20.31±4.12)、上臂肌围[(21.95±5.13) cm vs.(19.90±4.01)cm]及肱三头肌皮褶厚度[(12.05±2.05) mm vs.(10.45±2.11)mm]大于对照组(P<0.05)；白蛋白(ALB)[(39.95±5.01) g/L vs.(37.88±4.79)g/L]、前清蛋白(PA)[(0.30±0.06)g/L vs.(0.27±0.05)g/L]及总蛋白(TP)[(61.60±6.44)g/L vs.(59.16±5.23)g/L]均大于对照组(P<0.05)；CD3⁺、CD4⁺及CD4⁺/CD8⁺大于对照组(P<0.05)；营养不良发生率(3.92% vs. 15.69%)低于对照组(P<0.05)。结论基于归因理论的综合营养护理干预可改善老年COPD患者营养状况，促进血清营养学指标的恢复，有助于增强免疫功能，预防营养不良。
- 慢性阻塞性肺疾病 /
- 营养干预 /
- 归因理论 /
- 营养状况 /
- 免疫功能
Abstract: Objective The nutritional status of elderly patients with chronic obstructive pulmonary disease (COPD) is a significant predictor of prognosis. The objective of this study is to investigate the potential benefits of a comprehensive nutritional intervention based on attribution theory for elderly patients with COPD. Methods A total of 108 elderly patients with COPD treated at the Affiliated Hospital of Shaoxing University of Arts and Sciences from August 2021 to August 2023 were randomly assigned to either a control group (54 cases with traditional nutritional intervention) or an experimental group (54 cases with comprehensive nutritional intervention based on attribution theory). Ultimately, 51 cases were enrolled in each group. A comparison was made of the nutritional status, serum nutritional indexes, immune function and incidence of malnutrition of the two groups. Results The BMI[(22.09±4.67) vs. (20.31±4.12)]. Similarly, the upper arm muscle circumference [(21.95±5.13) cm vs. (19.90±4.01) cm] of the experimental group after 6 months of nursing and triceps skin fold thickness [(12.05±2.05) mm vs. (10.45±2.11) mm] were higher than those in the control group (P<0.05). The albumin (proportionate) [(39.95±5.01) g/L vs. (37.88±4.79) g/L] and prealbumin (PA) [(0.30±0.06)g/L vs. (0.27±0.05)g/L] and total protein (TP)[(61.60±6.44)g/L vs. (59.16±5.23)g/L] were higher than those in control group (P<0.05). CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were higher than those in the control group (P<0.05). Additionally, the incidence of malnutrition was lower in the experimental group (3.92% vs. 15.69%) than in the control group (P<0.05). Conclusion A comprehensive nutrition nursing intervention based on attribution theory has been demonstrated to improve the nutritional status of elderly patients with COPD, promote the recovery of serum nutritional indexes, and enhance immune function and prevent malnutrition.
- Chronic obstructive pulmonary disease /
- Nutrition intervention /
- Attribution theory /
- Nutritional status /
- Immune function
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表 1 2组慢性阻塞性肺疾病患者一般资料比较

Table 1. Comparison of general data between two groups of patients with COPD

组别	例数	性别(男/女，例)	年龄(x±s, 岁)	病程(x±s, 年)	NRS2002评分(x±s, 分)	第1秒用力呼气容积/用力肺活量的百分比(FEV₁/EVC，x±s, %)
对照组	51	31/20	64.56±3.11	5.11±1.45	4.11±0.76	69.90±8.11
试验组	51	26/25	64.88±4.02	5.07±0.97	4.03±0.85	70.95±9.54
统计量		0.994^a	0.450^b	0.164^b	0.501^b	0.599^b
P值		0.319	0.654	0.870	0.617	0.551
注：^a为χ²值，^b为t值。

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表 2 2组慢性阻塞性肺疾病患者护理前后营养状况比较(x±s)

Table 2. Comparison of nutritional status before and after care between two groups of patients with chronic obstructive pulmonary disease(x±s)

组别	例数	BMI		上臂肌围(cm)		肱三头肌皮褶厚度(mm)
组别	例数	护理前	护理6个月	护理前	护理6个月	护理前	护理6个月
对照组	51	18.80±3.10	20.31±4.12^b	18.09±3.10	19.90±4.01^b	8.79±2.01	10.45±2.11^b
试验组	51	18.75±3.26	22.09±4.67^b	18.18±4.77	21.95±5.13^b	8.90±1.17	12.05±2.05^b
统计量		0.079^a	2.909^c	0.113^a	3.457c	0.338^a	3.980^c
P值		0.937	0.030	0.910	0.001	0.736	<0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP<0.05。

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表 3 2组慢性阻塞性肺疾病患者护理前后血清营养学指标比较(x±s，g/L)

Table 3. Comparison of serum nutrition indicators before and after care between two groups of patients with chronic obstructive pulmonary disease(x±s, g/L)

组别	例数	ALB		PA		TP
组别	例数	护理前	护理6个月	护理前	护理6个月	护理前	护理6个月
对照组	51	35.67±5.78	37.88±4.79^b	0.24±0.04	0.27±0.05^b	56.98±5.11	59.16±5.23^b
试验组	51	35.87±6.11	39.95±5.01^b	0.25±0.03	0.30±0.06^b	57.03±5.65	61.60±6.44^b
统计量		0.170^a	2.934^c	1.428^a	4.456^c	0.047^a	3.967^c
P值		0.867	0.030	0.156	<0.001	0.923	<0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP<0.05。

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表 4 2组慢性阻塞性肺疾病患者护理前后免疫功能比较(x±s)

Table 4. Comparison of immune function before and after care between two groups of patients with chronic obstructive pulmonary disease(x±s)

组别	例数	CD3⁺(%)		CD4⁺(%)		CD4⁺/CD8⁺
组别	例数	护理前	护理6个月	护理前	护理6个月	护理前	护理6个月
对照组	51	36.31±7.01	39.88±5.11^b	35.98±5.51	39.11±4.79^b	1.27±0.35	1.49±0.32^b
试验组	51	36.60±5.07	45.45±6.02^b	36.22±6.12	43.03±5.61^b	1.19±0.37	1.70±0.44^b
统计量		0.239^a	6.767^c	0.208^a	4.231^c	1.122^a	4.012^c
P值		0.811	<0.001	0.836	<0.001	0.265	<0.001
注：^a为t值，^c为F值；与同组护理前比较，^bP<0.05。

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