不同肠内营养制剂对老年重症肺炎病人的血糖、营养状态及预后的影响

Effects of different enteral nutrition on blood glucose,nutrition and prognosis in elderly patients with severe pneumonia

目的探究不同肠内营养制剂对老年重症肺炎病人血糖、营养状态及预后的影响。方法选取2016年1月至2019年10月期间在本院接受治疗的老年重症肺炎病人60例作为研究对象,随机分为2组,根据给予的肠内营养制剂不同,分为TPF-D组和TPF组,每组各30例。TPF-D组给予瑞代,TPF组给予能全力,均为经鼻胃管匀速滴入。比较2组病人治疗期间平均血糖值(GLUave)、血糖变异系数(GLUcv)、最高血糖值(GLUmax)、最低血糖值(GLUmin)、住院期间的血糖差值(GLUdif)、高血糖发生率,及治疗前后营养状况、临床肺部感染评分(CPIS)、ICU入住时间、不良反应发生率。结果TPF-D组病人血糖相关事件发生率明显低于TPF组;治疗后,2组病人血清前白蛋白(PAB)及白蛋白(ALB)水平均比治疗前显著升高,且TPF-D组高于TPF组;治疗后2组CPIS较治疗前显著降低(P<0.05);且TPF-D组CPIS评分及ICU入住时间明显低于TPF组。TPF-D组腹泻、腹胀、恶心等不良反应发生率为6.67%,TPF组为20.00%,2组比较差异无统计学意义(P>0.05)。结论TPF-D能明显稳定老年重症肺炎病人的血糖水平,改善营养状况,控制炎症水平,缓解临床症状。

Objective To investigate the effects of enteral nutrition on blood glucose,nutrition and prognosis in the elderly patients with severe pneumonia.Methods Sixty elderly patients with severe pneumonia who were treated in our hospital from January 2016 to October 2019 were selected as research subjects.They were randomly divided into TPF-D group and TPF group,with 30 cases in each group.The blood glucose related indexes,nutritional status,clinical pulmonary infection scores(CPIS),28 d mortality,days in ICU and the incidence of adverse reactions of the two groups were recorded and compared.Results After treatment,the blood glucose related indexes in TPF-D group were significantly lower than those in TPF group(P<0.05).The serum levels of prealbumin(PAB)and albumin(ALB)in the two groups were significantly higher than those before treatment,especially in the TPF-D group.CPIS scores of the two groups were lower than those before treatment(P<0.05),especially in the TPF-D group.In addition,the incidence rate of adverse reactions such as diarrhea,bloating,and nausea in TPF-D group and TPF group was 6.67%and 20.00%(P>0.05),respectively.Conclusions TPF-D can contribute to stabilizing blood glucose levels,reducing inflammation,improving nutritional status,relieving clinical symptoms in the elderly patients with severe pneumonia.