早期肠内营养治疗ICU呼吸衰竭患者的临床效果观察

Clinical effect of early enteral nutrition on patients with respiratory failure in ICU

目的探讨早期肠内营养治疗重症监护室(ICU)呼吸衰竭患者的临床效果。方法选择2019年6月至2022年6月我院收治的100例ICU呼吸衰竭患者为研究对象,按随机数字表法分为对照组和实验组,每组50例。对照组给予肠外营养治疗,实验组给予早期肠内营养治疗,比较两组患者治疗前后的肺功能[一秒钟内从肺部呼出的强制性用力呼气容积(FEVI)、最大呼气容积(FVC)、肺活量(PEF)]改善情况;采用重症营养分析量表(NUTRIC评分)进行临床早期营养需求评估,判断营养风险等级;运用急性生理学和慢性健康状况系统(APACHEⅡ评分)评分及序贯器官衰竭评分(SOFA)进行评价两组患者的器官功能和健康状况;比较两组患者的血红蛋白、血清蛋白、体质量指数以及血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]。结果实验组的FEVI、FVC、PEF指标水平明显高于对照组,差异均有统计学意义(均P<0.05)。两组患者的APACHEⅡ、SOFA评分比较,实验组均低于对照组,差异均有统计学意义(均P<0.05)。实验组的血红蛋白、血清蛋白、体质量指数均明显高于对照组,差异均有统计学意义(均P<0.05)。两组患者的PaO_(2)、PaCO_(2)指标水平均较治疗前明显改善,且实验组的改善效果明显优于对照组,差值均有统计学意义(均P<0.05)。结论对ICU呼吸衰竭患者实施早期肠内营养治疗的临床疗效显著,与传统肠外营养治疗模式相比较,可显著改善机体营养状况,改善患者的肺功能和血气指标,具有较高的临床应用价值。

Objective To investigate the effect of early enteral nutrition on patients with respiratory failure in intensive care unit(ICU).Methods 100 patients with respiratory failure treated in our hospital from June 2019 to June 2022 were selected as the research objects.They were randomly divided into control group and experimental group,with 50 cases in each group.The control group was given parenteral nutrition treatment,and the experimental group was given early enteral nutrition treatment.The improvement of lung function[forced expiratory volume(FEVI),maximum expiratory volume(FVC),and pulmonary capacity(PEF)]before and after treatment was compared between the two groups.The Critical Nutrition Analysis Scale(NUTRIC score)was used to evaluate early clinical nutritional needs and determine the nutritional risk level.Acute physiology and chronic health status system score(APACHEⅡ)and sequential organ failure score(SOFA)were used to evaluate the organ function and health status of the two groups.The hemoglobin,serum protein,body mass index and blood gas analysis indexes[partial pressure of arterial oxygen(PaO_(2));partial pressure of arterial carbon dioxide(PaCO_(2))]of the two groups were compared.Results The levels of FEVI,FVC and PEF in experimental group were significantly higher than those in control group,with statistical significance(all P<0.05).The scores of APACHEⅡand SOFA in experimental group were lower than those in control group,and the differences were statistically significant(all P<0.05).The hemoglobin,serum protein and body mass index of experimental group were significantly higher than those of control group,with statistical significance(all P<0.05).PaO_(2)and PaCO_(2)indexes of 2 groups were significantly improved compared with before treatment,and the improvement effect of experimental group was significantly better than that of control group,with statistical significance(all P<0.05).Conclusion Early enteral nutrition therapy in ICU patients with respiratory failure has significant clinical efficacy.Compared with traditional parenteral nutrition therapy mode,it can significantly improve the nutritional status of the body,improve the lung function and blood gas indexes of patients,and has high clinical application value.