不同营养支持治疗在慢性阻塞性肺疾病急性加重期并呼吸衰竭患者中的应用效果  

Application Effect of Different Nutritional Support Therapy on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients Complicated with Respiratory Failure

作　　者：张燕敏[1] 壮健 唐亮[1] 

机构地区：[1]江苏省无锡市中医医院呼吸科,214000

出　　处：《实用心脑肺血管病杂志》2017年第8期64-68,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨不同营养支持治疗在慢性阻塞性肺疾病急性加重期(AECOPD)并呼吸衰竭患者中的应用效果。方法选取2015—2016年无锡市中医医院收治的AECOPD并呼吸衰竭患者90例,采用随机数字表法分为对照组、治疗1组、治疗2组,每组30例。对照组患者予以基础治疗,治疗1组患者在对照组基础上予以肠外营养支持治疗,治疗2组患者在对照组基础上予以肠内营养支持治疗;3组患者均连续治疗10 d。比较3组患者治疗前后营养指标[血红蛋白(Hb)、淋巴细胞计数、血清前清蛋白、血清清蛋白、血清转铁蛋白]、肝功能指标(丙氨酸氨基转移酶、γ-谷氨酰转肽酶、碱性磷酸酶),肾功能指标(血尿素氮、血肌酐)、血气分析指标[p H值、血氧分压(PO_2)、血二氧化碳分压(PCO_2)、HCO_3^-、氧合指数(OI)]、改良版英国医学研究会呼吸困难量表(m MRC)评分、肺功能指标[第1秒用力呼气容积占预计值的百分比(FEV1%)、残气量/肺总量比值(RV/TLC)]。结果治疗前3组患者Hb、淋巴细胞计数、血清前清蛋白、血清清蛋白、血清转铁蛋白水平比较,差异无统计学意义(P>0.05);治疗后治疗1组、治疗2组患者Hb、淋巴细胞计数、血清前清蛋白、血清清蛋白、血清转铁蛋白水平高于对照组(P<0.05)。治疗前3组患者丙氨酸氨基转移酶、γ-谷氨酰转肽酶、碱性磷酸酶、血尿素氮、血肌酐水平比较,差异无统计学意义(P>0.05);治疗后治疗1组、治疗2组患者丙氨酸氨基转移酶、γ-谷氨酰转肽酶、碱性磷酸酶水平高于对照组,血尿素氮、血肌酐水平低于对照组(P<0.05)。治疗前3组患者pH值、PO_2、PCO_2、HCO-3、OI比较,差异无统计学意义(P>0.05);治疗后治疗1组、治疗2组患者pH值、PO_2、OI高于对照组,PCO_2、HCO_3^-低于对照组(P<0.05)。治疗前3组患者mMRC评分、FEV_1%、RV/TLC比较,差异无统计学意义(P>0.05);治疗后治疗1组、治疗2组患者mMRC评分、RV/TObjective To investigate the application effect of different nutritional support therapy on acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） patients complicated with respiratory failure. Methods A total of 90 AECOPD patients complicated with respiratory failure were selected in the Traditional Chinese Medicine Hospital of Wuxi from 2015 to 2016,and they were divided into A group,B group and C group according to random number table,each of30 cases. Patients of the three groups received conventional treatment, meanwhile patients of B group received parenteral nutritional support therapy, while patients of C group received enteral nutritional support therapy; all of the three groups continuously treated for 10 days. Nutritional index（ including Hb,lymphocyte count,prealbumin,albumin and transferrin）,index of liver function（ including ALT,γ-GGT and AKP）,index of renal function（ including BUN and Scr）,blood-gas analysis results（ including pH value,PO2,PCO2,HCO3^-and OI）,mMRC score and index of pulmonary function（ including FEV1% and RV/TLC） were compared among the three groups before and after treatment. Results No statistically significant differences of Hb, lymphocyte count, prealbumin, albumin or transferring was found among the three groups（ P〉0. 05）,while Hb,lymphocyte count,prealbumin,albumin and transferring of B group and C group were statistically significantly higher than those of A group after treatment（ P〈0. 05）. No statistically significant differences of ALT,γ-GGT,AKP,BUN or Scr was found among the three groups before treatment（ P〈0. 05）; after treatment,ALT,γ-GGT and AKP of B group and C group were statistically significantly higher than those of A group, while BUN and Scr of B group and C group were statistically significantly lower than those of A group（ P〈0. 05）. No statistically significant differences of pH value,PO2,PCO2,HCO3^-or OI was found among the three groups before treatment（ P〉0. 05）; after treatment,pH value,PO2

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 营养支持 治疗结果 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]