慢性阻塞性肺疾病机械通气患者早期不同热量联合营养支持疗效比较

Comparison of efficacy of mechanical ventilation combined with nutritional support in different heat treatment in early chronic obstructive pulmonary disease patients

目的：探讨不同热量联合营养支持在慢性阻塞性肺疾病（COPD）机械通气患者早期治疗中的临床效果。方法选择商丘市第一人民医院2010年2月至2012年2月收治的 COPD机械通气患者80例，将其随机分为观察组与对照组，各40例，两组患者均采用静脉营养，给予观察组患者非蛋白热量15～20 kal·kg-1·d-1治疗，对照组患者采用30 kal·kg-1·d-1治疗，比较两组患者治疗10 d 动脉血气、血清总蛋白、血清白蛋白、成功脱概率及生存率。结果两组患者治疗10 d 后， PaO2、PaCO2指标较治疗前均有明显改善（均 P<0.05），两组患者 PaO2、PaCO2指标比较差异存在统计学意义（P<0.05）；两组患者血清总蛋白、血清白蛋白比较差异有统计学意义（P<0.05）；观察组患者成功脱概率为70%，对照组患者成功脱概率为50%，两组患者治疗效果比较差异存在统计学意义（P<0.05）。观察组患者死亡2例，存活率为95%，对照组患者死亡6例，存活率为85%，差异有统计学意义（P<0.05）。结论低热量联合营养支持在 COPD 机械通气患者早期治疗中，能够有效改善患者的动脉血气、血清总蛋白、血清白蛋白指标，促进患者康复，提高患者的生存率，值得推广使用。

Objective Toinvestigatetheclinicaleffectofdifferentheatcombinedwithnutritional support in the early treatment of COPD patients with mechanical ventilation. Methods in our hospital from 2010 February to 2012 February were treated 80 cases of COPD patients with mechanical ventilation were randomly divided into the observation group and the reference group, 40 cases in each group, two patients were treated with intravenous nutrition, the patients in the observation group were given non protein calorie 15~20 kal·kg-1·d-1 treatment, the reference group were treated by 30 kal·kg-1·d-1 treatment, compared two groups of patients 10 days of arterial blood gas, serum total protein, serum albumin, successfully weaning rate and survival rate. Results The two groups were treated for 10 days with PaO2, the PaCO2 index was significantly improved (P<0.05), there were significant differences in the observation group and the reference group were PaO2, PaCO2 index (P<0.05); the two group total protein, serum albumin and showed significant difference, compared with statistical significance (P<0.05); patients in the observation group successfully weaning rate is 70%, the reference group were successfully weaning rate is 50%, the treatment effect between the two groups have significant difference, compared with statistical significance (P<0.05); the patients in observation group and 2 patients died, the survival rate was 95%, the reference group were 6 cases of death, survival rate was 85%, with statistically significant differences(P<0.05). Conclusion Low calorie nutrition support can improve the patients arterial blood gas, serum total protein, serum albumin index in the early treatment of COPD patients with mechanical ventilation, promote the rehabilitation of patients, improve the survival rate of patients, is worthy to be popularized.