COPD急性期患者低碳水化合物肠内营养支持的临床观察

Enteral nutrition support with low carbohydrate for COPD patients during acute period

目的:观察慢性阻塞性肺病(COPD)急性期患者营养支持前后的蛋白质营养状况及呼吸功能。方法:选择COPD急性加重期合并呼吸衰竭患者64例,随机分为两组,试验组和对照组各32例。两组均经鼻喂管肠内营养支持2周,其中试验组采用低碳水化合物营养制剂,对照组采用正常匀浆制品。比较两组营养支持前后营养及免疫指标体重(BW)、血清白蛋白(ALB)、总蛋白(TP)、血红蛋白(HB)、淋巴细胞计数(LYM)和呼吸功能指标动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)的变化。结果:两组各项营养指标均优于治疗前,差异有统计学意义(P<0.05);试验组的PaO2、PaCO2与治疗前比较及与对照组同期比较均有统计学意义(P<0.05)。结论:合理肠内营养支持能改善COPD急性加重期合并呼吸衰竭患者的蛋白质营养状况,提高机体免疫能力,短期低碳水化合物营养支持能促进肺功能的恢复。

Objective：To observe and compare protein nutritional status and respiratory function of patients suffered from chronic obstructive pulmonary disease（COPD） in acute period before and after treatment.Methods：A total of 64 COPD patients in acute period with respiratory failure were randomly divided into trial group and control group,with 32 cases in each group.Both groups were fed by nasal tube for 2 weeks,with low carbohydrate nutrients for trial group and normal homogenate preparations for control group.Nutritional,immunological and respiratory indexes including body weight（BW）,serum albumin,total protein（TP）,hemoglobin（HB）,lymphocyte count,PaO_2 and PaCO_2 were observed and compared.Results：The protein nutritional parameters of trial group were significantly improved after treatment（P〈0.05）.PaO_2 and PaCO_2 in arterial blood of trial group significantly changed after nutrition support（P〈0.05）.Conclusions：Reasonable enteral nutrition support can improve nutritional status of COPD patients in acute period with respiratory failure,strengthen protein metabolism and immunological function.And low carbohydrate enteral nutrition support in short time can promote recovery of lung function.