慢性阻塞性肺疾病呼吸衰竭行机械通气患者营养支持疗效观察

The effects of nutritional support using mechanical ventilation in treating COPD patients with respiratory failure

目的探讨慢性阻塞性肺疾病(COPD)呼吸衰竭行机械通气患者营养支持治疗的效果。方法对43例COPD机械通气患者随机分成两组,A组23例常规治疗,B组20例在A组基础上加用营养支持治疗,2周后比较两组的血红蛋白(Hb)、血清总蛋白(Tp)、血清白蛋白(Alb)、血淋巴细胞总数(Tlc)、IgA、IgG及IgM及住院时间、撤机时间、病死率。结果A组患者在治疗2周后,Hb、Tp及Alb等营养指标均有明显下降(P<0.05),而B组治疗前、后无显著差异;免疫指标中,Tlc及IgA在A组治疗前、后无显著差异,而在B组治疗后有显著提高(P<0.05);IgG及IgM在A组治疗后显著下降,而在B组治疗后无显著差异;A组机械通气时间长,住院时间长,病死率高,与B组比较有显著差异(P<0.05)。结论营养支持在治疗COPD机械通气患者中能有效地改善营养指标,提高机体抗感染能力,大大缩短了病人机械通气时间及住院时间,并降低了病死率。

Objective To explore the effect of nutritional support using mechanical ventilation （MV） in treating COPD patients with respiratory failure. Methods 43 COPD patients using mechanical ventilation were at random divided into a control group（23 cases） and a observation group （20 cases）. The control groups were teated with basle therapy, and the similar patients in the observation ones were treated the same plus nutritional support. The group comparisons were made on the changes of Hb.Tp.Alb.Tlc.IgA.IgG.IgM and hospitalized time, ventiltion duration, mortality rate. The study period was 14 days. Results The series of nutritional parameters such as Hb.Tp and Aib had decreased significantly （1：＇〈0.05） in the control group, and there were no significant differences in the observation group; In the series of immunological parameters. Tic and IgA had not chsnged significantly in the control group, but had improvement significantly in the observation group （P〈0.05）,IgG and IgM decreased significantly in the control group, and there were no significantly defferences in observation one,, on the variables of ventilation duration, hospitalized time, mortality rate, the observation group waslower than the control one. Conclusions in treating COPD patients with respiration failure. Nutrirional support was effective while using MV interms of improving nutrition and immunity, shortening MV time, hospital stay time, and decreasing mortality raters.