肠内免疫营养治疗在慢性阻塞性肺疾病急性发作患者中的临床应用

发布时间：2018-06-17 17:06

本文选题：肺疾病 + 慢性阻塞性　；参考：《解放军医学杂志》2015年05期

【摘要】：目的探讨应用肠内免疫营养制剂对于慢性阻塞性肺疾病急性加重(A ECO P D)患者营养状况的改善效果及对免疫和急性炎性反应的影响。方法纳入2013年1月-2014年6月在海军总医院ICU住院且需行机械通气的AECOPD患者62例,随机分为免疫营养组(n=32,给予瑞能)和对照组(n=30,给予本院营养科自制匀浆膳)。两组使用等热量肠内营养,营养素经鼻肠管给予。入院当天及第14、18天抽取静脉血,检测血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TFN)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平,同时在床旁测上臂肌围(UAMC),比较两组14d脱机率及28d内的机械通气时间。结果免疫营养组患者14d脱机率明显高于对照组,28d内机械通气时间少于对照组(P0.05);PA、TFN及UAMC等营养指标明显高于对照组(P0.05),IL-6、CRP、TNF-α等免疫指标明显低于对照组(P0.05)。结论 AECOPD患者应用免疫肠内营养支持较匀浆膳能更好地改善患者的营养状态、免疫功能,并可下调急性炎症反应水平,提高早期撤机成功率,是一种更为合适的营养支持方法。
[Abstract]:Objective to investigate the effect of enteral immune nutrition preparation on nutritional status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and its effect on immune and acute inflammatory response. Methods Sixty-two AECOPD patients who were hospitalized in ICU of Naval General Hospital from January 2013 to June 2014 were randomly divided into immune nutrition group (n = 32) and control group (n = 30). The two groups were treated with isothermal enteral nutrition, and the nutrients were given through the naso-intestinal tube. Venous blood was collected on the day of admission and on the 18th day after admission. The levels of serum albumin (Alb), prealbumin (PAA), transferrin (TFN) C-reactive protein (TNF- 伪), TNF- 伪 (TNF- 伪) and interleukin-6 (IL-6) were measured. At the same time, the muscle circumference of the upper arm was measured by the bed side, and the weaning rate of 14 days and the mechanical ventilation time within 28 days were compared between the two groups. Results the weaning rate of the patients in the immune nutrition group was significantly higher than that in the control group in 14 days and that in the control group was significantly lower than that in the control group, such as P0.05, PA-TFN and UAMC, and the immune indexes such as IL-6 / CRPNF- 伪 in the control group were significantly lower than those in the control group. Conclusion compared with homogenate diet, immuno-enteral nutrition support can improve the nutritional status and immune function of AECOPD patients, and can down-regulate the level of acute inflammatory reaction and increase the success rate of early weaning. It is a more suitable nutritional support method for AECOPD patients.
【作者单位】：海军总医院重症医学科;
【分类号】：R563.9

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