摘要
目的:系统评价老年慢性阻塞性肺疾病(COPD)病人营养不良的发生率及其影响因素。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science和Cochrane Library中自建库至2024年12月发表的有关老年COPD病人营养不良发生率及影响因素的文献。由2名研究者独立进行文献筛选、质量评价、资料提取,应用Stata 17.0和RevMan 5.4软件进行数据分析。结果:共纳入20篇文献,涉及5 652例病人。Meta分析结果显示,老年COPD病人营养不良总体发生率为48%,病程[OR=1.50,95%CI(1.16,1.94),P<0.05]、呼吸困难程度[OR=2.29,95%CI(1.51,3.46),P<0.001]、多病共存[OR=1.94,95%CI(1.40,2.70),P<0.001]、呼吸机使用情况[OR=5.68,95%CI(1.48,21.80),P<0.05]、COPD病人自我评估测试(CAT)评分[OR=1.25,95%CI(1.14,1.39),P<0.001]、过去1年内急性加重次数[OR=2.16,95%CI(1.51,3.08),P<0.001]、疾病严重程度[OR=1.55,95%CI(1.19,2.02),P<0.001]是营养不良的主要影响因素。结论:老年COPD病人营养不良发生率高,多种因素导致营养不良发生,应尽早识别和筛查营养不良危险因素,制定合理营养摄入计划,早期实施干预措施,以延缓和降低营养不良的发生,减少不良结局的发生。
Objective:To systematically review the incidence and influencing factors for malnutrition in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:Literature on the incidence of malnutrition and its influencing factors in elderly COPD patients published from the establishment of databases to December 2024 were retrieved from CNKl,WanFang Data,VIP,CBM,PubMed,EMbase,Web of Science and Cochrane Library.Two researchers independently conducted literature screening,quality evaluation,and data extraction.Data analysis was performed using Stata 17.0 and RevMan 5.4 software.Results:Twenty articles were included,comprising 5652 participants.The results of Meta-analysis showed that the pooled prevalence of malnrtrition in elderly COPD patients was 48%.The main influencing factors for malnutrition were duration of illness(OR=1.50,95%CI 1.16-1.94,P<0.05),degree of dyspnea(OR=2.29,95%CI 1.51-3.46,P<0.001),multimorbidity(OR=1.94,95%CI 1.40-2.70,P<0.001),ventilator use(OR=5.68,95%CI 1.48-21.80,P<0.05),CAT score(OR=1.25,95%CI 1.14-1.39,P<0.001),number of acute exacerbations in the past 1 year(OR=2.16,95%CI 1.51-3.08,P<0.001),and severity of illness(OR=1.55,95%CI 1.19-2.02,P<0.001).Conclusion:The incidence of malnutrition is high in elderly COPD patients with multiple contributing factors.Early identification of risk factors,nutritional planing,and interventions are essential to reduce malnutrition and adverse outcomes.
作者
陈洁
廖翠红
肖艳华
CHEN Jie;LIAO Cuihong;XIAO Yanhua(School of Nursing,Gannan Medical University,Jiangxi 341000 China;The First Affiliated Hospital of Gannan Medical University)
出处
《循证护理》
2025年第16期3288-3294,共7页
Chinese Evidence-Based Nursing
关键词
老年人
慢性阻塞性肺疾病
营养不良
发生率
影响因素
META分析
循证护理
the elderly
chronic obstructive pulmonary disease,COPD
malnutrition
incidence
influencing factors
Meta-analysis
evidence-based nursing
