营养支持对于老年慢性阻塞性肺疾病急性发作合并呼吸衰竭患者的预后分析

Effects of nutritional support treatment on prognosis in elderly patients with chronic obstructive pulmonary disease acute exacerbation complicated with respiratory failure

目的探讨有效的营养支持对于老年慢性阻塞性肺疾病急性发作(AECOPD)合并呼吸衰竭患者预后的影响。方法采用连续入组法选择120例老年AECOPD合并呼吸衰竭患者,分为对照组及观察组,各60例,其中对照组给予常规治疗方案,观察组在常规治疗基础上给予胃肠内营养制剂营养支持方案治疗。观察比较2组患者治疗前后营养指标(体质量指数、上臂肌围、肱三头肌皮褶厚度、血清前白蛋白及白蛋白)的水平,以及血气分析指标动脉血二氧化碳分压(Pa CO2)、动脉血氧分压(Pa O2)的变化情况。结果治疗前2组间各营养指标及血气分析指标比较,差异均无统计学意义(P>0.05);治疗后,观察组各营养指标及血气分析指标较治疗前均有明显改善,差异均有统计学意义(P<0.05);治疗后观察组各营养指标及血气分析指标改善情况均优于对照组,差异均有统计学意义(P<0.05)。结论积极、合理的营养支持能够显著改善老年AECOPD合并呼吸衰竭患者的预后,加强改善其营养状况,可以进一步降低Pa CO2,提高Pa O2,在临床工作中可推广使用。

Objective To evaluate the curative effect of nutritional support treatment for the elderly patients with chronic obstructive pulmonary disease acute exacerbation（ AECOPD） complicated with respiratory failure. Methods120 elderly patients with AECOPD complicated with respiratory failure were divided into control group and observation group,with 60 cases in each group. Patients in control group received conventional treatment,and the patients in observation group received oral or suspending liquid of intestinal nutrition（ TPF-D） additionally,on basis of routine treatment. The level of body mass index,upper arm muscle circumference,triceps skinfold,serum prealbumin,albumin,and the level of arterial partial pressure of carbon dioxide（ Pa CO2）,arterial partial pressure of oxygen（ Pa O2） were detected and compared between two groups before and after treatment. Results There were no significant difference in each index between two groups before treatment（ P〉0. 05）. After treatment,the nutrition index and blood gas analysis index of the observation group were significantly improved compared with before treatment（ P〈0. 05）. The improvement of the nutritional indexes and blood gas analysis index were more significant than those in the control group after treatment（ P〈0. 05）. Conclusions The positive and reasonable nutritional support can significantly improve prognosis and nutritional status of the elderly patients with AECOPD complicated with respiratory failure on the basis of conventional treatment. It could decrease Pa CO2 and increase Pa O2 furthermore.