呼吸支持联合营养支持在高龄重症肺炎患者中的临床应用

Clinical application of respiratory support and nutritional support in treating elderly patients with severe pneumonia

目的:探讨呼吸支持联合营养支持在高龄重症肺炎患者中的临床应用。方法:将2016年5月-2017年5月在我院ICU治疗的78例高龄重症肺炎患者随机分为两组,对照组采用基础呼吸支持治疗,观察组采用阶梯式呼吸支持联合营养支持,比较两组的临床疗效、血气分析及营养指标、症状改善时间。结果:观察组治愈10例、显效15例、有效11例、无效3例,总有效率为92.31%,对照组治愈6例、显效12例、有效10例、无效11例,总有效率为71.79%,两组间差异有统计学意义(P<0.05);观察组治疗后Pa CO2(44.35±4.27)mm Hg、Pa O2(79.18±4.36)mm Hg、Hb(101.4±5.6)g/L、Alb(32.8±3.4)g/L,对照组治疗后Pa CO2(48.09±5.13)mm Hg、Pa O2(71.78±4.25)mm Hg、Hb(85.7±3.9)g/L、Alb(25.6±3.8)g/L,两组间差异有统计学意义(P<0.05);观察组呼吸机撤离时间、住ICU病房时间、住院时间较对照组明显缩短,两组间差异有统计学意义(P<0.05)。结论:呼吸支持联合营养支持在高龄重症肺炎患者疗效显著,能快速改善患者呼吸衰竭症状,加强营养供给,缩短机体通气时间,具有积极的临床意义。

Objective： To explore the clinical application of respiratory support and nutritional support in treating elderly patients with severe pneumonia. Methods： 78 patients with severe pneumonia received ICU treatment in our hospital from May 2016 to May 2017 were randomly divided into two groups; the control group was treated by respiratory support treatment; the observation group was given stepwise respiratory support combined with nutritional support; the clinical efficacy of the two groups, blood gas analysis and nutritional index, symptom improvement time were compared. Results： After treatment, 10 cases were cured; 15 cases were significantly effective;11 cases were effective and 3 cases were ineffective; the effective rate was 92.31% in the observation group. In the control group, 6 cases were cured; 12 cases were significantly effective; 10 cases were effective and 11 cases were ineffective; the effective rate was 71.79% in the control group（P〈0.05）. After treatment, Pa CO2, Pa O2, Hb and Alb in the observation group was（44.35±4.27）mm Hg,（79.18±4.36）mm Hg,（101.4±5.6）g/L and（32.8±3.4）g/L respectively; while those in the control group was（48.09±5.13） mm Hg,（71.78±4.25）mm Hg,（85.7±3.9）g/L and（25.6±3.8） g/L respectively; the difference was statistical significance（P〈0.05）. The ventilator weaning time, the length of stay in ICU ward and the length of stay in the observation group were significantly shorter than those in the control group（P〈0.05）. Conclusion： Respiratory support with nutritional support was effective on elderly patients with severe pneumonia. It could rapidly relieve the symptoms of respiratory failure, strengthen the nutrition supply and shorten the ventilation time, with positive clinical significance.