慢性阻塞性肺疾病急性加重期并呼吸衰竭患者实施肠内营养的护理干预

Nursing intervention of enteral nutrition to the patients with chronic obstructive pulmonary disease on acute exacerbation complicating respiratory failure

目的：观察肠内营养支持在慢性阻塞性肺疾病急性加重期并呼吸衰竭患者中的效果。方法回顾分析2012年1月～2013年12月在本科住院7d以上的慢性阻塞性肺疾病急性加重期呼吸衰竭患者，均需留置人工气道和留置胃管，住院48h内给予肠内营养支持。检测患者治疗前1d和治疗后第7天血红蛋白及血清白蛋白含量及观察相关并发症情况。结果肠内营养支持中患者血红蛋白和血清白蛋白含量均较前降低；出现腹泻24例，胃液反流5例，腹胀12例，低血糖反应2例。结论肠内营养支持是医治危重症患者的一项重要内容，特别是早期治疗，越来越受到认可和重视，所以规范流程，个性化护理是保证肠内营养顺利完成，减少并发症的必要条件。

Objective To study the effects of enteral nutrition in patients with chronic obstructive pulmonary disease on acute exacerbation complicating respiratory failure. Methods Retrospectively study about the patients with chronic obstructive pulmonary disease on acute exacerbation and respiratory failure hospitalized in ICU for more than 7 days from January 2012 to December 2013. All the patients are needed to be indwelled artificial airway and gastric tube, supported with enteral nutrition within 48 hours in hospital. Hemoglobin and serum albumin content are checked and the related complications are observed in the first day before treatment and the seventh day after treatment. Results The hemoglobin and serum albumin in patients with enteral nutrition were lower. Diarrhea 24 cases, gastric reflux 5 cases, abdominal distension 12 cases and hypoglycemia reaction 2 cases occurred. Conclusion The enterable nutrition support is an important treatment of critically ill patients, especially in early treatment. It is receiving more and more recognition and attention. Hence, standardized processes and personalized nursing are the necessary conditions to ensure the smooth completion of enteral nutrition and reduce the complications.