肠内营养途径对重症肺炎患者营养支持效果的影响  

Effect of enteral nutrition pathways on nutrition support efficacy in patients with severe pneumonia

作　　者：林令君 于勇 侯玉溪 LIN Lingjun;YU Yong;HOU Yuxi(Department of Intensive Care Unit,Chu Hsien-I Memorial Hospital,Tianjin Medical University,Tianjin 300134,CHINA;不详)

机构地区：[1]天津医科大学朱宪彝纪念医院重症医学科(国家卫生健康委员会激素与发育重点实验室、天津市代谢性疾病重点实验室),300134 [2]淄博市中心医院重症医学科

出　　处：《江苏医药》2019年第10期1001-1004,1007,共5页Jiangsu Medical Journal

基　　金：天津医科大学朱宪彝纪念医院科研基金(2018ZXY01)

摘　　要：目的探讨不同肠内营养途径对重症肺炎患者营养支持效果的影响。方法将70例ICU重症肺炎患者随机均分为两组,分别采用鼻肠管(A组)和鼻胃管(B组)持续泵入肠内营养液实施营养支持。比较两组治疗前后营养指标、炎性指标、肠内营养达到目标剂量所需时间、胃肠道并发症、氧合指数、2周内撤机成功率以及急性生理与慢性健康状况评分(APACHEⅡ评分)的变化。结果与治疗前相比,两组治疗后白蛋白、前白蛋白和淋巴细胞计数水平升高,WBC、降钙素原、CRP水平以及APACHEⅡ评分降低;其中,A组变化更加明显(P<0.05)。与B组相比,A组肠内营养达到目标剂量所需时间缩短,呕吐、误吸及应激性溃疡发生率降低,治疗后氧合指数、2周内撤机成功率提高(P<0.05)。结论经鼻肠管肠内营养较鼻胃管能更好地改善重症肺炎患者的营养状况,减轻炎症反应,促进疾病恢复。Objective To investigate the effect of different support pathways on the nutrition support efficacy in the patients with severe pneumonia.Methods Seventy patients with severe pneumonia were continuously pumped with enteral nutrition via nasointestinal tube(group A,35 cases)or nasogastric tube(group B,35 cases).The nutritional status,inflammatory index,time of achieving target dose,gastrointestinal complications,oxygenation index,successful rate of weaning within two weeks and acute physiology and chronic health evaluation(APACHEⅡ)were compared between two groups.Results Compared with before,the levels of albumin,prealbumin and total lymphocyte count were inceased,while the levels of WBC,PCT and CRP and APACHEⅡscore were decreased in both groups after treatment(P<0.05),which were changed more obviously in group A(P<0.05).Compared with group B,the time of achieving target dose and incidences of vomit,aspiration and stress ulcer were decreased,while oxygenation index and successful rate of weaning within two weeks after treatment were increased in group A(P<0.05).Conclusion Compared with nasogastric tube,the enteral nutrition support via nasointestinal tube could more effectively improve the nutritional status,reduce inflammatory response,promote recovery and decrease mortality in the patients with severe pneumonia.

关 键 词：重症肺炎 肠内营养 鼻肠管 鼻胃管 

分 类 号：R459[医药卫生—治疗学]