静脉营养对慢性阻塞性肺病呼吸衰竭患者营养状态的影响

Effects of parenteral nutrition on malnourished chronic obstructive pulmonary disease patients with respiratory failure

目的观察静脉营养支持对慢性阻塞性肺病(COPD)呼吸衰竭患者营养状态的影响。方法观察COPD急性加重、存在呼吸衰竭伴营养不良患者营养支持(A组)和非静脉营养支持(B组)人体测量、血生化指标、免疫功能、呼吸功能的变化,比较两组平均住院日和带机时间。结果A组患者体重、三头肌皮皱厚度(TSF)、上臂肌围长(MAMC)、上臂中部臂围(MAC)、血清转铁蛋白(TRF)、前白蛋白(PALB)、甘油三酯(TG)均显著增加,B组患者测量值下降,两组比较,差异有显著性意义(P<0.05);两组免疫功能指标、血气指标均有明显改善(P<0.05);A组平均住院与带机时间均较B组短,差异有显著性意义(P<0.05)。结论静脉营养支持能显著改善COPD呼吸衰竭患者的营养状态,增强免疫功能,缩短住院时间和带机时间。

Objective To investigate the feasibility and effectiveness of energy- and protein-rich nutritional supplements for nutritionally depleted chronic obstructive pulmonary disease （ COPD） patients. Methods Forty-five malnourished patients with COPD and respiratory failure were randomized into a parenteral nutrition { PN） group or a non-parenteral nutrition { NPN） group. Body measurement, biochemical indices, immune function and respiratory function were measured, and the duration of hospitalization and mechanical ventilation was compared. Results The mean body weight, triceps skin fold thickness, mean arm muscle circumference and mid-arm circumference, serum transferrin, prealbumin, and triglyceride were significantly higher in PN group than NPN group （P 〈 0.05）. pH, PaO2, PaCO2, HCO3 and PaO2/FiO2 in both groups improved significantly（P 〈 0. 05 ）. The duration of hospitalization and mechanical ventilation was significantly shorter in PN group than NPN group （ P 〈 0.05 ）. Conclusion Parenteral nutritional supplementation can improve the nutritional status and respiratory function and reduce the duration of hospitalization and mechanical ventilation for patients with COPD and respiratory failure.