营养治疗在重度营养不良肺结核患者中的应用体会

Nutrition therapy for pulmonary tuberculosis patients with severe malnutrition

目的 探讨不同营养治疗方案对重度营养不良肺结核患者的临床疗效.方法 回顾性分析沈阳市胸科医院收治的82例肺结核合并重度营养不良患者的临床资料,按照不同的营养治疗方案,分为肠内营养组（EN组,40例）和肠外营养组（PN组,42例）,比较两组治疗前后营养指标、免疫指标及健康评分SF-36的变化.结果 治疗后,EN组淋巴细胞总数、白蛋白、血红蛋白浓度、体质量指数均明显高于PN组（P〈0.05）;EN组CD3^＋显著高于PN组（P〈0.05）,EN组CD4^＋、CD8^＋、CD4^＋/CD8^＋均明显低于PN组（P〈0.05）;EN组总体健康、躯体功能、精神状态、疼痛与总分均显著低于PN组（P〈0.05）.结论 EN应用于重度营养不良合并肺结核患者可明显改善其营养指标、免疫指标,较为显著地提升患者的生存健康,对患者预后有良好的促进作用,是一种价格低廉,效果显著的可行方案.

Objective To investigate the clinical efficacy of different nutrition therapy for pulmo-nary tuberculosis patients with severe malnutrition. Methods A retrospective study was performed on 82 cases of pulmonary tuberculosis with severe malnutrition. According to the different methods,they were di-vided into the enteral nutrition group（EN group,n=40）and the parenteral nutrition group（PN group,n=42）. The nutritional indexes before and after treatment,the changes of immune index and the health score SF-36 were compared. Results After the treatment, in EN group, TLC, HB and BMI were significantly higher than those in PN group（P〈0. 05）;in EN group,CD3^＋ was significantly higher than that in PN group （P〈0. 05）,CD4^＋,CD8^＋,CD4^＋ / CD8^＋ were significantly lower than those in PN group（P〈0. 05）;in EN group,the overall health,physical function,mental state,pain and total score were significantly lower than those in PN group（P〈0. 05）. Conclusion The application of EN for pulmonary tuberculosis patients with severe malnutrition can significantly improve the nutritional index,immune index and significantly improve patient survival state. It has a good effect on the prognosis of the patients,and it is an inexpensive and effec-tive feasible method.