呼吸机相关肺炎危重症患者使用合生元制剂联合肠内营养序贯治疗的临床研究  

Clinical effect of sequential treatment with synthroid combined with enteral nutrition in critically ill patients with ventilator-associated pneumonia

作　　者：李文艳 许志强 Li Wenyan;Xu Zhiqiang(Department of Critical Care Medicine,Anyang Cancer Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳市肿瘤医院重症医学科,河南安阳455000

出　　处：《中国药物与临床》2024年第20期1341-1345,共5页Chinese Remedies & Clinics

摘　　要：目的分析危重症患者呼吸机相关肺炎实施合生元制剂联合序贯肠内营养措施的效果。方法运用随机数字表法将2021年8月至2024年2月河南省安阳市肿瘤医院重症医学科收治的危重症呼吸机相关肺炎患者118例分为对照组(59例)、试验组(59例)。对照组实施序贯肠内营养治疗,试验组实施合生元制剂联合序贯肠内营养治疗。比较2组患者治疗前及治疗2周后营养状态指标(胃肠功能评分、转铁蛋白、白蛋白、前白蛋白)、自身免疫状态(CD4^(+)、CD8^(+)、CD3^(+)、CD4^(+)/CD8^(+))、炎症因子(降钙素原、C反应蛋白)与健康评分,以及治疗期间腹泻、腹胀、反流发生情况。结果2组患者治疗2周后胃肠功能评分较治疗前降低,试验组低于对照组(t=16.043,P<0.05);转铁蛋白、白蛋白、前白蛋白水平较治疗前升高,试验组高于对照组(t=2.578、6.798、4.335,P均<0.05)。2组患者治疗2周后CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+)较治疗前升高,试验组高于对照组(t=7.332、2.176、4.471,P均<0.05);CD8^(+)较治疗前降低,试验组低于对照组(t=3.511,P<0.05)。2组患者治疗2周后降钙素原、C反应蛋白水平及急性生理与慢性健康评分较治疗前降低,试验组低于对照组(t=8.221、11.768、7.266,P均<0.05)。2组患者治疗期间的腹泻、腹胀、食管反流发生率差异无统计学意义(χ^(2)=0.619,P>0.05)。结论合生元制剂联合序贯肠内营养措施可调整危重症患者呼吸机相关肺炎患者营养状态与胃肠功能,提升免疫力,降低患者体内炎症,恢复患者健康,安全性良好。Objective To analyze the effect of the implementation of synthroid combined with sequential enteral nutrition measures in critically ill patients with ventilator-associated pneumonia.Methods A total of 118 patients with critically ill ventilator-associated pneumonia admitted to Anyang City Cancer Hospital from August 2021 to February 2024 were divided into a control group(59 cases)and a experimental group(59 cases)by the randomized numerical table method.The control group implemented sequential enteral nutrition therapy,and the experimental group implemented synthroid combined sequential enteral nutrition therapy.The nutritional status in-dicators(gastrointestinal function score,transferrin,albumin,prealbumin),autoimmune status(CD4^(+),CD8^(+),CD3^(+),CD4^(+)/CD8^(+)),inflammatory factors(procalcitonin,C-reactive protein),and health scores of the two groups before treatment and 2 weeks after treatment were compared,as well as the occurrence of diarrhea,abdominal distension,and reflux during treatment.Results Gastrointestinal function scores of patients in the 2 groups were lower after 2 weeks of treatment than before treatment,and the experi-mental group was lower than the control group(t=16.043,P<0.05);transferrin,albumin,and pre-albumin levels were higher than before treatment,and the experi-mental group was higher than the control group(t=2.578,6.798,and 4.335,all P<0.05).After 2 weeks of treat-ment,the patients in the 2 groups had higher levels of CD4^(+),CD3^(+),CD4^(+)/CD8^(+)were higher than before treatment,and the experimental group was higher than the control group(t=7.332,2.176,4.471,all P<0.05);CD8^(+)was lower than before treatment,and the experimental group was lower than the control group(t=3.511,P<0.05).After 2 weeks of treatment,the levels of procalcitonin,C-reactive protein,and acute physiological and chronic health scores of the two groups of patients decreased compared to before treatment,and the experimental group was lower than the control group(t=8.221,11.768,7.266,all P<0.05).There was no

关 键 词：危重症 肺炎 呼吸机相关性 合生元 肠内营养 

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