慢性阻塞性肺病加重期患者早期肠内营养支持研究

Early Enteral Nutrition Support on the Patients with COPD in Acute Exacerbation Stage

目的探讨慢性阻塞性肺病(COPD)加重期患者早期肠内营养支持的治疗效果。方法将58例COPD加重期患者分为早期肠内营养组33例和肠外营养组25例,分别于治疗前、治疗第5d及治疗第10d检测各项生化指标,并观察两组并发症情况,计算死亡率。结果早期肠内营养与肠外营养组治疗后各营养指标均有所下降,早期肠内营养组的蛋白类指标降幅低于肠外营养组(P<0.05)。早期肠内营养组感染性并发症发生率(27.27%)低于肠外营养组(56.00%),非感染性并发症发生率(69.70%)高于肠外营养组(40.00%),差别均有统计学意义(P<0.05)。早期肠内营养与肠外营养组死亡率差别无统计学意义(P>0.05)。结论COPD加重期患者进行早期肠内营养支持可有效控制患者营养状况的恶化,纠正或减轻患者的负氮平衡,对于减少感染性并发症具有重要意义。

To investigate the effect of enteral nutrition on patients with COPD during acute exacerbation stage. Methods Subjects hospitalized for an acute exacerbation of COPD （n=58） were assigned into two groups： enteral nutrition group （n= 33） or parenteral nutrition group （n=25）. The blood indexes of nutrition at day 5 and day 10, the incidence of complication and the mortality were observed. Results Less decrease of serum proteins was detected in the enteral nutrition group as compared with that in the parenteral alimentation group （day 5 P〈0.05 ,day 10 P〈0.01）. The incidence of infectious complications such as fungus infection, urinary tract infection and tube-induced infection in the enteral nutrition group （27.27%）was significantly lower than that （56.00%） in the parenteral alimentation group （P〈0.05）, but higher frequencies of non-infectious complications such as diarrhea was observed in former group （40.00% vs 69.70%, P〈0.05）. There were no changes in the mortality between these two groups. Conclusion Treatment with enteral nutrition during an acute exacerbation stage of COPD may prevent patients against the deterioration of nutritional status and retrieve negative nitrogen balance. Furthermore, it can promote the host immunity and lower the incidence of infectious complications.