高能低糖营养液在COPD机械通气病人营养支持中的疗效观察

The study of high-fat and low-carbohydrate enteral nutrition in nutrition treatment of COPD patients with mechanical ventilation

目的:探讨慢性阻塞性肺疾病(COPD)并发呼吸衰竭病人机械通气时,早期应用高能低糖肠内营养对病人治疗效果的影响。方法:将40例病人随机分为试验组(使用高能低糖肠内营养液)和对照组(使用普通肠内营养液),治疗10d。比较两组病人每分钟通气量(VE),二氧化碳生成量(VCO2),动脉血二氧化碳分压(PaCO2),机械通气时间,血清清蛋白,免疫球蛋白,总淋巴细胞计数等。结果:治疗后,试验组病人的PaCO2、VCO2与对照组相比有明显改善(P<0.05);机械通气时间亦短于对照组(P<0.05)。两组病人的血清清蛋白、免疫球蛋白和淋巴细胞计数等无显著性差异(P>0.05)。结论:COPD机械通气病人,尽早合理地应用高能低糖肠内营养支持治疗,能有效地减少病人CO生成量,降低呼吸商,缩短机械通气时间,提高综合治疗的疗效。

Objective：To investigate the effect of enteral nutritional support in treating COPD patients with respiratory failure and mechanical ventilation.Methods：40 patients were randomly divided into two groups：high-fat and low-carbohydrate enteral nutritional solution group（HL group） and ordinary enteral nutritional solution group（control group）.The volume of expired gas（VE）,carbon dioxide production（VCO2）,partial pressure of carbon dioxide（PaCO2）,respiratory quotient（RQ）,serum albumin,immunoglobulin,total lymphocyte count（TLC） were detected.Results：VCO2 and PaCO2 were significantly decreased in HL group compared with control group（P0.05）.Mechanical ventilation time in HL group was significantly decreased when compared with control group （P0.05）.Conclusion：In treating COPD patients with normal digestive function,early special high-fat and low-carbohydrate enteral nutritional solution has better therapeutic effects.