结核病与肺部健康杂志 ›› 2017, Vol. 6 ›› Issue (3): 235-240.doi: 10.3969/j.issn.2095-3755.2017.03.000

• 论著 • 上一篇    下一篇

饮食干预对营养不良初治涂阳肺结核患者治疗转归的影响

李冰,张士霞,吕士珍   

  1. 277500山东省枣庄市王开传染病医院护理部(李冰、吕士珍);山东省滕州市级索中心卫生院 (张士霞)
  • 收稿日期:2017-06-12 出版日期:2017-09-30 发布日期:2017-09-30
  • 作者简介:李冰

The influence of dietary intervention on the treatment outcome of new smear positive pulmonary tuberculosis patients with malnutrition at the beginning of treatment

LI Bing, ZHANG Shi-xia, LV Shi-zhen   

  1. The Nursing Department, Wangkai Infectious Diseases Hospital in Zaozhuang, Zaozhuang, 277500, China
  • Received:2017-06-12 Online:2017-09-30 Published:2017-09-30

摘要: 目的 探讨饮食干预对营养不良的初治涂阳肺结核患者预后的影响。 方法 以2013年1月至2013年12月入住我院的营养不良的初治涂阳肺结核患者58例为对照组;以2014年1月至2014年12月在我院住院的营养不良的初治涂阳肺结核患者60例为干预组;入院后两组患者均常规接受抗结核药物治疗。对照组患者住院期间,给予常规健康教育;干预组:由营养专项监督小组,对全院医生、护士进行营养知识培训,在患者入院24 h内、入院后2周及出院时对患者进行营养评估,调整个体纳入能量标准,对患者进行饮食干预。两组患者分别于入组时及治疗2个月、5个月、6个月时,进行痰菌、胸部X线摄影复查,观察痰菌阴转情况、病灶变化情况及治疗效果。结果 患者出院时,经治疗和干预后,干预组营养不良患者占20.00%(12/60),明显低于对照组
[65.51%(38/58)],差异有统计学意义(χ2=25.023, P﹤0.01);干预组满意度达96.67%(58/60),优于对照组
[77.58%(45/58))],差异有统计学意义(Z=9.72 ,P﹤0.05);干预组病灶显著吸收者占51.67%(31/60),明显高于对照组
[31.03%(18/58)],差异有统计学意义(χ2=37.168, P﹤0.01);干预组患者痰菌转阴率为83.33%(50/60),高于对照组
[53.44%(31/58)],差异有统计学意义(χ2=12.237,P﹤0.01);干预组病灶无变化情况6.7%(4/60)明显低于对照组29.3%(17/58),差异有统计学意义(χ2=10.336, P﹤0.01)。结论 对营养不良的初治涂阳肺结核患者进行饮食干预,可明显纠正患者营养不良,提高结核病治愈率。

Abstract: Objective To explore the influence of dietary intervention on the treatment outcome of new smear positive pulmonary tuberculosis (PTB) patients with malnutrition. Methods 60 new smear positive PTB patients with malnutrition admitted in our hospital from January 2013 to December 2013 were in control group, and 60 new smear positive PTB patients with malnutrition admitted in our hospital from January 2014 to December 2014 were in intervention group, the patients of both groups received anti-TB therapy. Routine health education was conducted for patients in control group during their stay in hospital. Patients’ nutritional assessment was performed within 24 hours of admission, two weeks after admission and when they left the hospital in intervention group, the individual energy standard of the patients was adjusted and dietary intervention was conducted by the doctors and nursed who received nutrition knowledge training by special monitoring group on nutrition. The reexamination of sputum and chest radiography of the patients in the two groups were performed at the enrollment, after 2 months’ treatment, 5 months’ treatment and 6 months’ treatment, in order to get the information of sputum conversion, the lesion changes and treatment outcome. Results When the patients were discharged from the hospital, the patients with malnutrition accounted for 20.00% (12/60) in the intervention group after treatment and intervention, which was significantly less than that (65.51%, 38/58) in the control group (χ2=25.023, P﹤0.01). The degree of satisfaction in the intervention group reached up to 96.67% (58/60), which was higher than the control group (77.58%, 45/58), and the difference was statistically significant (Z=9.72,P﹤0.05). The patients in the intervention group whose lesions were significantly absorbed accounted for 51.67% (31/60), which was obviously higher than the that in the control group (31.03%, 18/58)(χ2=37.168, P﹤0.01). The sputum negative conversion rate of the patients in the intervention group was 83.33% (50/60), and that in the control group was 53.44% (31/58), with statistically significant difference (χ2=12.237,P ﹤0.01). The rate of no changes in lesion in the intervention group (6.7%, 4/60) was significantly less than the that in the control group (29.3%, 17/58)(χ2=10.336, P﹤0.01). Conclusion Dietary intervention on smear positive PTB patients at the beginning of treatment can evidently correct the situation of malnourish, and it can also improve the cure rate of the patients.