早期个性化肠内营养支持对机械通气患者的临床治疗效果分析

目的探讨早期个性化肠内营养支持对机械通气患者的临床治疗效果。方法2014年1月至2015年10月机械通气患者84例，按照随机数字表法分为观察组与对照组，其中对照组43例，观察组41例，对照组按照基础能量供给计算能量供给量，观察组按照实际能量供给计算能量供给量。比较两组患者的血红蛋白（Hb）、白蛋白（ALB）、VAP发生率、机械通气时间、住院时间及住院费用的变化情况。结果早期个性化营养支持14d后，观察组血红蛋白（Hb）、白蛋白（ALB）含量大于对照组（P〈0．05）；观察组机械通气时间、ICU住院时间、ICU住院总费用与对照组比较明显缩短，差异有统计学意义（P〈0．05），观察组呼吸机相关性肺炎（VAP）发生率低于对照组，但差异无统计学意义（P〉0．05）。结论实施早期个性化肠内营养支持更能满足机械通气患者的生理需求，改善患者的营养状况，降低患者的机械通气时间、ICU住院时间和ICU住院总费用，从一定程度上降低预防VAP发生率，促进患者早期康复。

Objective To investigate clinical efficacy of the early personalized enteral nutrition in the patients with mechanical ventilation in ICU. Methods A randomized controlled trial was carried out.84 mechanically ventilated patients were admitted to the intensive care unit of the Affiliated Hospital of Hai nan University from 2014.1 to 2015.10.These patients were randomly divided into two groups according to the random number table method.In the control group （n=43） the energy supply was calculated according to the basic energy expend formula, while in the experiment group （ n=41 ） according to the actual energy expend formula.Hemoglobin, albumin, occurrence rate of ventilator-associated pneumonia （ VAP ） , ICU stay, duration of mechanical ventilation and the hospitalization expense were compared between experiment group and control group. Results 14 days after enteral nutrition, hemoglobin content and albumin content of experimental group were higher than those of control group patients in the experimental group, duration of mechanical ventilation and ICU stay were shorter compared with control group, the hospitalization expense was decreased （ P〈0.05 ） . Occurrence rate of ventilator -associated pneumonia was no significant difference （ P〉0.05 ） . Conclusions The implementation of early personalized enteral nutrition can meet the requirements of the patients with mechanical ventilation in ICU, ICU stay, duration of mechanical ventilation and the hospitalization expense are decreased.A certain degree of the occurrence rate of ventilator-associated pneumonia （ VAP ） is reduced, the outcomes of mechanical ventilation patients are improved.