肠内营养支持治疗在慢性阻塞性肺疾病并发呼吸衰竭病人的疗效观察

发布时间：2018-08-06 11:55

【摘要】：目的:探讨肠内营养(EN)在治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭使用无创通气治疗病人中的应用价值。方法:将58例COPD并发呼吸衰竭使用无创通气治疗病人按随机数字表法分为治疗组和对照组,每组29例。两组病人均给予常规治疗,避免使用糖皮质激素。治疗组病人给予鼻饲EN液,行EN支持治疗14d。观察两组病人EN治疗前后血红蛋白(Hb)、血清总蛋白(TP)、清蛋白(ALB)、体质量(Wt)、肱三头肌皮皱厚度、上臂肌围、外周血总淋巴细胞计数(TLC)、Ig A、Ig G、Ig M、无创通气时间以及使用有创机械通气的病例数、入住ICU时间等指标。结果:治疗组病人治疗14 d后,Hb、TP和ALB较治疗前明显升高(P0.05),Wt较治疗前显著增加(P0.05)。与对照组比较,治疗组病人Hb、TP、ALB和Wt亦有明显增加(P0.05);TLC、Ig A、Ig G和Ig M明显升高(P0.05);无创通气时间和入住ICU时间明显缩短(P0.05),使用有创通气的病例数明显下降(P0.05)。结论:对COPD并发呼吸衰竭的病人,合理的营养支持治疗可改善机体的营养状态,提高机体的免疫功能,缩短无创通气和入住ICU时间,降低有创通气的比率。
[Abstract]:Objective: to evaluate the value of enteral nutrition (EN) in the treatment of chronic obstructive pulmonary disease (COPD) complicated with respiratory failure by non-invasive ventilation. Methods: 58 patients with COPD complicated with respiratory failure were randomly divided into treatment group (n = 29) and control group (n = 29). Both groups were given routine treatment to avoid the use of glucocorticoid. The patients in the treatment group were given en solution by nasal feeding and treated with en support for 14 days. Before and after en treatment, the body mass of hemoglobin (Hb), total protein (TP), albumin (ALB), body mass, (Wt), triceps muscle skin wrinkle thickness and upper arm muscle circumference were observed. Peripheral blood total lymphocyte count (TLC), Ig G G G M, noninvasive ventilation time, the number of cases using invasive mechanical ventilation, the time of admission to ICU, and so on. Results: after 14 days of treatment, the TP and ALB of the patients in the treatment group were significantly higher than those before treatment (P0.05) and Wt was significantly higher than that before treatment (P0.05). Compared with the control group, the patients in the treatment group also increased significantly (P0.05), the time of noninvasive ventilation and the duration of ICU were significantly shortened (P0.05), and the number of cases using invasive ventilation was significantly decreased (P0.05). Conclusion: for patients with COPD complicated with respiratory failure, proper nutritional support therapy can improve the nutritional status, improve the immune function, shorten the time of noninvasive ventilation and stay in ICU, and reduce the rate of invasive ventilation.
【作者单位】：杭州市第三人民医院ICU;
【分类号】：R563.8;R563.9

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