不同肠内营养方式对ICU危重症患者发生呼吸机相关性肺炎及预后情况的影响  

Effect of different enteral nutrition on ventilator-associated pneumonia and prognosis in critically ill patients in ICU

作　　者：甘平 刘克远 GAN Ping;LIU Ke-yuan(Department of Critical Care Medicine,Chongqing Armed Police Force Hospital,Chongqing 400061,China)

机构地区：[1]武警重庆总队医院重症医学科,重庆400061

出　　处：《临床肺科杂志》2020年第6期850-853,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨不同肠内营养方式对重症监护病房(ICU)危重症患者发生呼吸机相关性肺炎(VAP)及预后影响。方法选择我院于2017年1月至2019年1月期间收治的ICU重症患者82例,采用随机数字表法随机分为A组41例与B组41例。A组患者采用鼻肠管肠内营养方式,B组患者采用鼻胃管肠内营养方式。比较两组治疗前后营养指标变化,VAP发生情况,机械通气时间和住ICU时间,及预后情况。结果两组治疗后Alb、PA和TF水平较治疗前升高,差异具有统计学意义(P<0.05);A组治疗后Alb、PA和TF水平高于B组,差异具有统计学意义(P<0.05)。A组VAP发生率(19.51%)低于B组(48.78%),差异具有统计学意义(P<0.05)。A组机械通气和住ICU时间短于B组,差异具有统计学意义(P<0.05)。A组病死率(12.20%)低于B组(34.15%),差异具有统计学意义(P<0.05)。结论鼻肠管肠内营养方式对ICU危重症患者效果良好,可减少VAP发生,预后良好。Objective To investigate the effect of different enteral nutrition on ventilator-associated pneumonia(VAP) and prognosis in critically ill patients in intensive care unit(ICU). Methods 82 ICU patients admitted to our hospital from January 2017 to January 2019 were randomly divided into the group A(41 cases) and the group B(41 cases). The group A received enteral nutrition through nasogastric tube, while the group B received enteral nutrition through nasogastric tube. The changes of nutritional indexes, VAP occurrence, mechanical ventilation time, ICU stay and prognosis were compared between the two groups before and after treatment. Results After treatment, the levels of Alb, PA and TF in the two groups were higher than those before treatment(P<0.05). The levels of Alb, PA and TF in the group A were higher than those in the group B(P<0.05). The incidence of VAP in the group A(19.51%) was lower than that in the group B(48.78%)(P<0.05). The duration of mechanical ventilation and ICU stay in the group A was shorter than that in the group B(P<0.05). The mortality of the group A(12.20%) was lower than that of the group B(34.15%)(P<0.05). Conclusion Nasogastric enteral nutrition has a good effect on ICU critically ill patients, which can reduce the occurrence of VAP and has a good prognosis.

关 键 词：鼻肠管肠内营养 鼻胃管肠内营养 ICU危重症 呼吸机相关性肺炎 预后 

分 类 号：R459.7[医药卫生—急诊医学] R563.1[医药卫生—治疗学]