高脂肪低糖肠内营养对呼吸科危重症病人营养状况和呼吸功能的影响

Effect of high fat and low carbohydrate enteral nutrition on the nutritional status and respiratory function of patients in respiratory intensive care unit

目的:观察呼吸科危重症病人进行高脂肪低糖类肠内营养(EN)治疗后,营养状况和呼吸功能指标的变化。方法:选择呼吸科危重症病人120例,随机分为营养组(60例)和对照组(60例)。两组病人均接受相同的抗感染和对症治疗,营养组采用高脂肪低糖EN液(瑞能),对照组采用普通匀浆膳。分别于营养治疗前1 d和治疗后第14天测定血p H值、二氧化碳分压(Pa CO2)、氧分压(Pa O2)、呼吸商(RQ)、每分钟通气量(VE)、二氧化碳生成量(VCO2)、氧耗量(VO2)、氧合指数(Pa O2/Fi O2)以及血清总蛋白(TP)、清蛋白(ALB)、血红蛋白(Hb)、氮平衡(NB)等指标。结果:治疗第14天后,营养组病人的RQ、VCO2、VO2Pa CO2、Pa O2、Pa O2/Fi O2均较对照组显著改善(P<0.05);营养组TP、ALB、NB均明显优于对照组(P<0.05)。两组病人治疗后各项指标均较治疗前有明显的改善(P<0.05)。结论:呼吸科危重症病人应用高脂肪低糖EN支持可显著改善营养状况和呼吸功能。

Objective： To observe the nutritional status and respiratory function of the patients in respiratory intensive care unit after high fat and low carbohydrate enteral nutrition treatment. Methods：120 patients in the respiratory intensive care unit were divided into two groups： nutritional group（ 60cases） and control group（ 60 cases）. The two groups accepted the same anti-infection and symptomatic treatment. In addition,the nutritional group was given high fat and low carbohydrate enteral nutrition treatment. The blood gas analysis（ p H,Pa CO2,Pa O2,Pa O2/ Fi O2value） and RQ,VE,VCO2,VO2 were observed; indicators such as TP,ALB,Hb and nitrogen balance were separately determined one day before nutritional support and fourteen days after nutritional support. Results： Fourteen days after nutritional supports,RQ,VCO2,VO2,Pa CO2,Pa O2,Pa O2/ Fi O2 were all significantly better in nutritional group than control group（P〈0. 05）. There was significant difference between nutritional group and control group in TP,ALB and nitrogen balance. Conclusion： The high fat and low carbohydrate enteral nutrition treatment can improve the nutritional state and respiratory function of the patients in respiratory intensive care unit.