慢性阻塞性肺病并发呼吸衰竭病人早期肠内营养支持的临床研究

Clinical research of early enteral nutrition support in COPD complicated with respiratory failure patients

目的:观察慢性阻塞性肺病(COPD)并发呼吸衰竭病人EEN支持的疗效。方法:63例COPD并发呼吸衰竭病人在开始机械通气时,随机分为EEN组32例和延迟EN(DEN)组31例,比较两组病人营养支持2周后的各项生化指标、机械通气时间、并发症和病死率等。结果:治疗2周后,EEN组病人血清总蛋白、ALB、PA和Hb水平无明显下降(P>0.05),但DEN组上述指标较治疗前明显下降,差异有显著性意义(P<0.05)。EEN组与DEN组相比,机械通气时间明显缩短,腹胀、腹泻、消化道出血、二重感染、肝功能损害、高血糖等发生率明显降低,病死率亦有所降低,差异有显著性意义(P<0.05)。结论:COPD并发呼吸衰竭病人行EEN支持治疗,能改善病人的营养状况,减少并发症,缩短机械通气时间和降低最终病死率,是较好的营养支持方式。

Objective： To investigate the curative effect of early enteral nutrition support in patients with COPD complicated with respiratory failure. Methods： When mechanical ventilation began, 63 patients in the acute phase of COPD complicated with respiratory failure were divided into two groups： the early enteral nutrition group （EEN group, n = 32） or the delayed enteral nutrition group（ DEN group, n = 31 ）. After two weeks, the nutritional indexes, the times of mechanical ventilation, the incidence of complication and the mortality were observed. Results： Two weeks later, there was significant difference between EEN group and DEN group in total protein, albumin, prealbumin and hemoglobin （P 〈 0.05 ）. And the times of mechanical ventilation were decreased significantly in EEN group compared with that in DEN group. The incidence of diarrhea, abdominal swelling, alimentary tract hemorrhage, liver dysfunction, high blood glucose and mortality were significantly lower in EEN group. Conclusion： Compared to DEN group, EEN can improve the nutritional condition reduce complication, shorten the time of ventilation and decrease mortality in patients with COPD complicated with respiratory failure.