摘要
目的探讨慢性阻塞性肺疾病(COPD)患者机械通气早期合适的营养支持方式。方法 56例COPD机械通气患者随机分为肠内营养组(27例)、肠内外联合营养组(29例),分别给予肠内营养(EN)及肠内外联合营养。观察机械通气7 d内高血糖、电解质紊乱、EN不耐受发生率及脱机成功率,并检测患者血浆白蛋白、前白蛋白、转铁蛋白、D-乳酸、二胺氧化酶水平的变化。结果肠内外联合营养组患者治疗7 d内的脱机率和EN不耐受率明显低于肠内营养组(P<0.05);高血糖、电解质紊乱发生率两组差异不明显(P>0.05),肠内外联合营养组患者的前白蛋白、转铁蛋白、D-乳酸、二胺氧化酶水平改善优于肠内营养组(P<0.05)。结论肠内外营养联合治疗能较快改善COPD机械通气患者早期营养水平,保护肠道屏障功能,提高早期撤机成功率,是一种较为合适的营养支持方法。
Objective To explore the appropriate way of early nutritional support in chronic obsructive pulmonary disease（COPD）patients who recieved mechanical ventilation.Methods 56 COPD patients with mechanical ventilation were randomly assigned to enteral nutrition group received enteral nutrition（27 patients）and joint group received enteral and parenteral nutrition（29 patients）.And then we investigated the incidences of hyperglycemia,electrolyte disturbance,EN intolerance and successful rate of weaned off mechanial ventilation within 7 days after mechanical ventilation,respectively.In addition,we measured the changes of serum albumin,prealbumin,transferrin,D-lactate and diamine oxidase.Results The incidence of EN intolerance in joint group was significantly lower than enteral nutrition group（P0.05）.The successful rate of weaned off mechanical ventilation in joint group was higher than enteral nutrition group（P0.05）.The incidences of hyperglycemia and electrolyte disturbance showed no significant statistical diference between enteral nutrition group and joint group（P0.05）.The improvement of prealbumin,transferrin,D-lactate and diamine oxidase in joint group were all better than that in enteral nutrition group（P0.05）.Conclusion Enteral combined with parenteral nutrition could improve the early nutrition level of COPD patients who received mechanical ventilation.It was an approproate nutrition way to protect intestinal barrier function and increase the successful rate of early weaned off mechanical ventilation for COPD patients who received mechanical ventilation.
出处
《医学综述》
2011年第7期1089-1091,共3页
Medical Recapitulate
基金
上海市浦东新区卫生系统优秀学科带头人计划(PWRd200606)
上海市浦东新区卫生局基金项目(PW2009A-31)
关键词
慢性阻塞性肺疾病
机械通气
早期营养支持
Chronic obsructive pulmonary disease
Mechanical ventilation
Early nutrition support
