呼吸机相关性肺炎患者肠内营养与肠外营养支持疗效比较

发布时间：2019-03-31 16:42

【摘要】：目的:探讨肠内营养(EN)支持与肠外营养(PN)支持对呼吸机相关性肺炎(VAP)患者预后的影响。方法:100例VAP患者分EN组(50例,经鼻胃管给予肠内营养混悬液)和PN组(50例,给予静脉营养)。观测两组患者营养指标(入院第1、7、14天血清白蛋白、前白蛋白、血红蛋白水平)和临床结局指标(营养达标率、达标所需时间、机械通气时间、ICU入住时间、住院时间、感染性休克发生率及脱机成功率)的差异。结果:入组后EN组与PN组患者血清白蛋白、前白蛋白、血红蛋白水平随时间推移变化不大(F时间=0.453、0.132、0.583,P0.05),EN组血清白蛋白、前白蛋白水平均高于PN组(F组间=15.564、23.340,P0.05)。EN组营养达标率高于PN组(χ2=10.391,P0.001),达标所需时间短于PN组(t=4.010,P=0.003),机械通气时间短于PN组(t=3.121,P=0.007)。两组ICU入住时间、住院时间、感染性休克发生率及脱机成功率差异无统计学意义(P0.05)。结论:VAP患者行EN支持可更快更好地改善营养状况,并缩短机械通气时间。
[Abstract]:Objective: to investigate the effect of enteral nutrition (EN) and parenteral nutrition (PN) on prognosis of patients with ventilator-associated pneumonia (VAP). Methods: one hundred patients with VAP were divided into two groups: EN group (50 cases, receiving enteral nutrition suspension via nasogastric tube) and PN group (50 cases, given parenteral nutrition). The nutritional indexes (serum albumin, prealbumin, hemoglobin level on the 1st, 7th, 14th day after admission) and clinical outcome indexes (nutritional attainment rate, time required to reach the standard, duration of mechanical ventilation, length of stay of ICU, length of stay in hospital) and clinical outcomes were observed in the two groups. The incidence of septic shock and the success rate of weaning were different. Results: the levels of serum albumin, prealbumin and hemoglobin in EN group and PN group changed little with time (F time = 0.453, 0.132, 0.583, P0.05), EN group, P 0.05). The level of prealbumin was higher than that of PN group (F = 15.564, 23.340, P0.05), the rate of reaching the standard in). EN group was higher than that in PN group (蠂 2 脳 10.391, P0.001), and the time required for reaching the standard was shorter than that of PN group (t = 4.010, P < 0.003). The duration of mechanical ventilation was shorter than that of PN group (t = 3.121, P = 0.007). There was no significant difference in the length of stay, hospital stay, incidence of septic shock and success rate of weaning between the two groups (P0.05). Conclusion: EN support can improve nutritional status and shorten mechanical ventilation time in patients with VAP.
【作者单位】：郑州大学第一附属医院内科;郑州大学第一附属医院呼吸内科;郑州大学第一附属医院综合ICU;郑州大学第一附属医院护理部;
【基金】：河南省卫生厅科技攻关项目201203032
【分类号】：R563

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