EN启动时机对急性呼吸窘迫综合征机械通气患者的效果分析

Analysis of the Effect of EN Activation Timing on Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome

目的探究肠内营养支持(EN)启动时机对急性呼吸窘迫综合征(ARDS)机械通气患者的影响。方法择取2019年1—12月期间该院收治的110例ARDS机械通气患者为研究对象,按照抽签法分为两组,对照组55例和观察组55例。对照组行晚期EN,观察组行早期EN,比较两组患者治疗前后白蛋白(ALB)、前白蛋白(PA)、降钙素原(PCT)、总胆红素(TBIL)水平,呼吸力学指标和肺功能指标。结果治疗后观察组ALB(38.53±2.31)g/L和PA水平(396.85±11.28)mg/L、氧合指数(PaO_(2)/FiO_(2))(238.75±20.48)mmHg高于对照组(30.42±2.25)g/L、(351.12±10.47)mg/L、(167.99±18.74)mmHg,PCT (5.12±1.14)ng/L、TBIL (11.38±1.78)μmol/L水平、气道降压(PIP)(15.46±3.57)cmH_(2)O、平均气道压(MPaw)(6.03±1.47)cm H_(2)O、气道平台压(Pplat)(9.86±1.42)cm H_(2)O低于对照组(10.65±1.38) ng/L、(23.65±1.83)umol/L、(20.36±3.41)cmH_(2)O、(8.53±1.22)cmH_(2)O、(15.36±1.63)cmH_(2)O,差异有统计学意义(t=18.652、22.036、18.904、22.912、35.645、7.361、9.706、18.868,P<0.05)。结论早期开展EN对ARDS机械通气患者营养指标、呼吸功能和肺功能等具有良好改善作用。

Objective To explore the effect of the timing of enteral nutrition support(EN)on mechanically ventilated patients with acute respiratory distress syndrome(ARDS).Methods The 110 mechanically ventilated patients with ARDS admitted to the hospital from January to December 2019 were selected as the research objects,and were divided into two groups according to the lottery method,with 55 cases in the control group and 55 cases in the observation group.The control group received late EN,and the observation group received early EN.The levels of albumin(ALB),prealbumin(PA),procalcitonin(PCT),total bilirubin(TBIL),respiratory mechanics and lung function were compared between the two groups before and after treatment.Results After treatment,the observation group's ALB(38.53±2.31)g/L and PA levels(396.85±11.28)mg/L,PaO2/FiO2(238.75±20.48)mmHg were higher than those of the control group(30.42±2.25)g/L,(351.12±10.47)mg/L,(167.99±18.74)mmHg,PCT(5.12±1.14)ng/L,TBIL(11.38±1.78)μmol/L level,peak airway pressure(PIP)(15.46±3.57)cmH_(2)O,MPaw(6.03±1.47)cmH_(2)O,Pplat(9.86±1.42)cmH_(2)O was lower than the control group(10.65±1.38)ng/L,(23.65±1.83)μmol/L,(20.36±3.41)cmH_(2)O,(8.53±1.22)cmH_(2)O,(15.36±1.63)cmH_(2)O,the difference was statistically significant(t=18.652,22.036,18.904,22.912,35.645,7.361,9.706,18.868,P<0.05).Conclusion Early development of EN has a good effect on improving the nutritional indicators,respiratory function and lung function of patients with mechanical ventilation in ARDS.