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題 名 | 使用COUNT營養指標評估重症慢性肺阻塞疾病之預後=Evaluation of COUNT Nutritional Status on Clinical Outcomes in Critically Ill COPD Patients |
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作 者 | 林晏如; 李靜怡; 蔡育君; 陳玉如; 洪永瀚; | 書刊名 | 臺灣營養學會雜誌 |
卷 期 | 35:1 2010.03[民99.03] |
頁 次 | 頁1-8 |
分類號 | 411.3 |
關鍵詞 | 慢性肺阻塞疾病; 重症; 呼吸器依賴; 預後; COPD; Critically ill patients; Ventilation dependency; Outcomes; |
語 文 | 中文(Chinese) |
中文摘要 | 慢性阻塞性肺疾病(chronic obstructive pulmonary disease COPD)患者中發生營養不良的比例為20-60%,此營養不良狀態會影響患者呼吸肌功能、造成呼吸的衰竭,以及增加脫離呼吸器的困難度。然而,目前很少研究調查重症患者的營養狀況,也沒有應用理想的營養評估方法,因此,本研究欲利用CONUT(Controlling Nutritional status)作為營養評估工具,綜合血清白蛋白量、總膽固醇量與淋巴球總數等指標,預測COPD患者使用呼吸器的預後狀況,藉由簡易與客觀的生化數據評估營養狀態,以作為營養計劃指標參考。本研究採回溯性調查,收集2005年6月至2006年12月醫學中心內科加護病房的COPD患者共99名,記錄血液生化值、身高、體重、疾病嚴重度(APACHE score)、使用呼吸器天數、加護病房(intensive care unit, ICU)天數、以及住院天數,進行描述性統計;另外,COUNT分數結果顯示使用呼吸器的COPD患者營養不良比例為93%,再依患者CONUT分數區分四組,分別是營養正常組、營養不良輕度組、中度組和嚴重組,與各項影響因子進行分析性統計,結果發現營養不良狀況與待在ICU天數、使用呼吸器天數、以及住院天數的增加具統計意義(p<0.0001),也與死亡率呈現統計意義(p=0.002)。本篇研究說明使用CONUT評估呼吸衰竭的C○PD患者,分數評比大於5分時,為中與重度營養不良時,明顯增加呼吸器依賴比例及加護中心和住院天數。 |
英文摘要 | Twenty percent to 60% of stable chronic obstructive pulmonary disease (COPD) patients experience malnutrition in the hospital. The malnutrition status adversely affects respiratory muscle function and causes difficulty weaning, even resulting in respiratory failure. However, malnutrition surveys are very rare and not practical in critically ill patients and those with COPD. To explore the proper nutritional plan care, this study used the Controlling Nutritional Status (CONUT) assessment containing assay data of albumin contents, total cholesterol contents, and total lymphocyte counts in blood to evaluate the nutritional status and its relation with clinical outcomes in COPD patients on ventilator support. Data on 99 COPD patients in a medical intensive care unit (ICU) were collected from June 2005 to December 2006. Information including biochemical data, height, body weight, APACHE Ⅱ score, lengths of stay in the ICU and hospital, duration of mechanical ventilation, and mortality were recorded, when these patients were admitted to the ICU. We divided these patients into tour groups: normal, mild malnutrition, moderate malnutrition, and severe malnutrition, by CONUT. We performed descriptive and analytical statistics. Our results showed that 93% of patients had a malnourished status. The nutritional status of these patients by CONUT scoring was correlated with a longer duration of ventilation support, longer lengths of stay in the ICU and hospital (p<0.0001), and mortality (p=0.002). This study demonstrated that a CONUT score of ≥5 in COPD patients with ventilator support significantly increases ventilation dependency, and lengths of stay in the ICU and hospital. |
本系統中英文摘要資訊取自各篇刊載內容。