肠内营养对老年重症肺炎患者预后的影响  

Effect of Enteral Nutrition on Prognosis of Elderly Patients with Severe Pneumonia

作　　者：段红丽 徐建淮[1] 郑洋[2] Duan Hongli;Xu Jianhuai;Zheng Yang(Department of Geriatrics,Suzhou Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu,215001,P.R.China;Department of Respiratory and Critical CareMedicine,Ruijin Hospital Affiliated to Shanghai Jiaotong University,Shanghai,200025,P.R.China)

机构地区：[1]南京医科大学附属苏州医院老年病科,江苏苏州215001 [2]上海交通大学医学院附属瑞金医院呼吸与危重症医学科,上海200025

出　　处：《老年医学与保健》2020年第6期1009-1012,1017,共5页Geriatrics & Health Care

摘　　要：目的观察肠内营养对老年性重症肺炎患者预后的影响,为老年性重症肺炎的采取营养支持治疗提供依据。方法选取2015年8月-2020年8月在苏州医院住院治疗的老年性重症肺炎患者54例,按随机数字表法分为观察组(n=27)和对照组(n=27)。对照组采用美罗培南治疗,观察组在对照组治疗的基础上增加肠内营养支持。分别在治疗前和治疗4周后,评估并比较2组血清指标(白蛋白、血红蛋白、转铁蛋白和血清总蛋白)值、免疫球蛋白(IgA、IgG和IgM)水平、炎性因子[血降钙素原(PCT)和C-反应蛋白(CRP)]水平、肺功能[用力肺活量(FEV1)和最大呼气流量(PEF)]及抗生素使用时间。结果治疗4周后,2组在血清指标(白蛋白、血红蛋白、转铁蛋白和血清总蛋白)、免疫球蛋白(Ig A、Ig G和Ig M)、炎性因子(PCT和CRP)和肺功能(FEV1和PEF)水平得到明显改善并优于同组治疗前(P<0.05),且观察组的上述表达指标改善明显优于对照组(P<0.05)。观察组抗生素使用时间明显少于对照组(P<0.05)。结论肠内营养可显著提高老年患者免疫功能,减少抗生素使用时间,改善患者预后,具有一定的临床应用价值。Objective To investigate the effect of enteral nutrition on the prognosis of elderly patients with severe pneumonia,and provide a basis for nutritional support for elderly patients with severe pneumonia.Methods 54 cases of elderly patients with severe pneumonia who were treated in Suzhou Hospital from August 2015 to August 2020 were selected and divided into observation group(n=27)and control group(n=27)according to the random number table method.The control group was treated with meropenem,and the observation group was supplemented with enteral nutrition support on the basis of the treatment of the control group.Before treatment and 4 weeks after treatment,the serumindicators(albumin,hemoglobin,transferrin,and total serumprotein),immunoglobulin(IgA,IgG,and IgM),and inflammatory factors[plasma procalcitonin(PCT)and C-reactive protein(CRP)],lung function[forced vital capacity(FEV1)and maximumexpiratory flow(PEF)]and antibiotic use time were evaluated and compared between the two groups.Results After 4 weeks of treatment,the levels of serum indexes(albumin,hemoglobin,transferrin and total serum protein),immunoglobulin(IGA,IgG and IgM),inflammatory factors(PCT and CRP)and pulmonary function(FEV1 and PEF)in the two groups were significantly better than those before treatment in the same group(P<0.05),and the above indexes of the observation group were significantly better than those of the control group(P<0.05).The use time of antibiotics in the observation group was significantly shorter than that in the control group(P<0.05).Conclusion Enteral nutrition can significantly improve the immune function of elderly patients,reduce the use of antibiotics time,improve the prognosis of patients,and has a certain clinical application value.

关 键 词：老年 重症肺炎 肠内营养 美罗培南 肺功能 免疫球蛋白 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统] R459.3[医药卫生—内科学]