慢性阻塞性肺疾病急性加重期患者的强化肠内营养治疗  

Enhanced enteral nutrition therapy for patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：李全业[1] 仇正锋 张国培[2] 向斌[2] 顾铭忠[1] LI Quanye;QIU Zhengfeng;ZHANG Guopei;XIANG Bin;GU Mingzhong(Department of Emergency Medicine,2.Intensive Care Unit,Yancheng Hospital Affiliated to Medical College of Southeast University,Yancheng,Jiangsu,224000)

机构地区：[1]东南大学医学院附属盐城医院急诊医学科,江苏盐城224000 [2]东南大学医学院附属盐城医院重症医学科,江苏盐城224000

出　　处：《实用临床医药杂志》2020年第14期86-89,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨经鼻饲管给予促胃肠动力药物的强化肠内营养治疗方案在行机械通气的慢性阻塞性肺疾病急性加重期(AECOPD)患者中的效果。方法将60例AECOPD患者随机分为对照组和治疗组,每组30例。对照组使用常规营养治疗模式,治疗组应用肠内营养治疗联合促胃动力药物。比较2组患者血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)、转铁蛋白(TF)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血尿素氮(BUN)、血清肌酐(Scr)、空腹血糖(Glu)水平。比较2组患者机械通气时间、留置ICU时间、总住院时间、营养达标时间、28 d病死率。观察2组并发症发生情况。结果治疗第3、7天,治疗组PA、ALB、TF、ALT、AST水平显著优于对照组(P<0.05),2组其他指标比较无显著差异(P>0.05)。治疗组患者机械通气时间、留置ICU时间、总住院时间、营养达标时间显著短于对照组(P<0.05),而2组患者28 d病死率比较无显著差异(P>0.05)。治疗组发生呕吐4例,腹胀6例,腹泻2例,吸入相关性肺炎5例;对照组发生呕吐2例,腹胀5例,腹泻2例,吸入相关性肺炎3例。2组并发症发生情况比较,差异无统计学意义(P>0.05)。结论经鼻饲管给予胃肠动力药物的强化肠内营养治疗方案可显著改善AECOPD患者的预后,缩短患者机械通气时间、留置ICU时间、总住院时间、营养达标时间。Objective To observe the effect of enhanced enteral nutrition therapy with gastric motility drugs through nasogastric tube in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)by mechanical ventilation.Methods Totally 60 patients with AECOPD were randomly divided into control group and treatment group,with 30 cases in each group.The control group was treated with conventional nutrition therapy,while the treatment group was treated with enteral nutrition therapy and gastric motility drugs.Levels of hemoglobin(Hb),prealbumin(PA),albumin(ALB),transferrin(TF),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),serum creatinine(Scr),fasting blood glucose(Glu)were compared between the two groups.The duration of mechanical ventilation,duration in ICU,total hospitalization time,time to achievement of nutritional target and mortality within 28 days were compared between the two groups.The complications of the two groups were observed.Results The levels of PA,ALB,TF,ALT and AST in the treatment group were significantly better than those in the control group on the 3 rd and 7 th day of treatment(P<0.05),but there were no significant differences in other indexes between the two groups(P>0.05).The duration of mechanical ventilation,duration in ICU,total hospitalization time,and time to achievement of nutritional target in the treatment group were significantly shorter than those in the control group(P<0.05),but there was no significant difference in mortality within 28 days between the two groups(P>0.05).There were 4 cases with vomiting,6 cases with abdominal distension,2 cases with diarrhea and 5 cases with aspiration-associated pneumonia in the treatment group,and there were 2 cases with vomiting,5 cases with abdominal distension,2 cases with diarrhea and 3 cases with aspiration-associated pneumonia in the control group.There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Enhanced enteral

关 键 词：慢性阻塞性肺疾病急性加重期 早期肠内营养治疗 促胃动力药物 营养目标 吸入相关性肺炎 

分 类 号：R563[医药卫生—呼吸系统]