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(P<0.05),Wt较治疗前显著增加(P<0.05)。与对照组比较,治疗组病人Hb、TP、ALB和Wt亦有明显增加(P<0.05);TLC、Ig A、Ig G和Ig M明显升高(P<0.05);无创通气时间和入住ICU时间明显缩短(P<0.05),使用有创通气的病例数明显下降(P<0.05)。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。
Objective： To explore the clinical value of enteral nutrition in patients with chronic obstructive pulmonary disease（ COPD） accompanied by respiratory failure who had received non-invasive positive pressure ventilation（ NIPPV）. Methods： Fifty-eighty patients were randomly divided into enteral nutrition group and control group,with 29 patients in each group. All patients received ragulaor treatment. In addition,patients in enteral nutrition group were given intestinal nutrition via indwelling nasogastric tubes for 15 days. The concentrations of hemoglobin,plasma total protein and albumin,body weight,triceps skin fold thickness,upper arm muscle circumference,the duration of NIPPV,the number of patients receiving invasive mechanical ventilation and the length of ICU stay were measured before and after treatment. Results： Compared with pretreatment values,blood biochemical parameters and body mass index values were significantly increased 15 days after treatment in enteral nutrition group（P〈0. 05）. When compared with control group,enteral nutrition obviously increased blood biochemical parameters and body mass index values,and decreased the duration of NIPPV,the length of ICU stay and the rate of invasive mechanical ventilation usage（P〈0. 05）. Conclusion： Enteral nutrition can improve nutritional status,shorten the length of ICU stay,and decrease the rate of invasive mechanical ventilation usage in patients with COPD accompanied by respiratory failure.
出处
《肠外与肠内营养》
CAS
北大核心
2015年第3期164-167,共4页
Parenteral & Enteral Nutrition
关键词
肠内营养
慢性阻塞性肺疾病
呼吸衰竭
无创呼吸机辅助通气
Enteral nutrition
Chronic obstructive pulmonary disease
Respiratory failure
Non-invasive positive pressure ventilation
作者简介
李辉，主治医师，医学本科，从事危重症医学专业。
