早期营养治疗与呼吸机相关性肺炎的关系研究

Relationship between early nutrition therapy for elderly patients and incidence of ventilator-associated pneumonia

目的 研究呼吸重症监护病房老年患者早期营养治疗与呼吸机相关性肺炎的关系.方法 我院RICU的64例插管使用呼吸机的老年患者,分为A组和B组.记录入院时白蛋白水平、APACHE Ⅱ评分、住RICU时间和合并症情况,第1-3天每天肠内营养、肠外营养占总热量比率、总热量与标准热量的比率以及供能方式.分析热量供给与VAP的关系.结果 VAP患者24例,未发生VAP 41例.合并症人数在两组间无统计学差异;在72 h内,非VAP组平均摄入热量为目标热量的77.7%,VAP组为目标热量的99.2%,具有统计学差异.结论入院后72 h内摄入热量增加是老年有创机械通气患者发生呼吸机相关性肺炎的危险因素.

Objective To study the relationship between early nutrition therapy for elderly patients and inci dence of ventilatorassociated pneumonia. Methods 64 elderly patients treated with intubated breathing machine were divided into the group A and the group B. Their albumin levels on admission, APACHE RICU score, dura tion of hospital stay, complications, enteral nutrition and parenteral nutrition to total heat ratio were recorded and ana lyzed. Results There were 24 patients with VAP and 41 patients without VAP. The chisquare test showed there was no significant difference in complications between the two groups. Within 72 hours, the average calorie intake was 77. 7% of the target heat in the nonVAP group, and 99. 2% of the target heat in the VAP group. Conclusion Within 72 hours after admission the increasing caloric intake is the risk factor of elderly patients with ventilatorassoci ated pneumonia.