摘要
目的研究肠内和肠外两种不同营养方式对重症肺炎患者的预后价值分析。方法选取我院2016年3月—2017年12月我院收治的重症肺炎患者62例,按不同营养补充方式分为对照组与观察组,每组31例,对照组给予胃肠外营养,观察组给予肠内营养。比较2组免疫功能、营养状况、有创机械通气时间和并发症情况。结果2组治疗后血红蛋白(HGB)、清蛋白(ALB)、前血清蛋白(PAB)值均较治疗前增高,且观察组高于对照组(P<0.05)。2组治疗后IgG、IgA、IgM值均高于治疗前,且观察组高于对照组(P<0.05)。2组治疗后CD4+/CD8+、CD3+水平高于治疗前,且观察组显著高于对照组,CD8+水平低于治疗前,且观察组低于对照组(P<0.05)。观察组有创时间短于对照组,VAP发生率低于对照组(P<0.05)。观察组误吸、腹泻、腹胀、胃潴留发生情况高于对照组(P<0.05),2组代谢障碍发生情况比较差异无统计意义(P>0.05)。结论早期肠内营养较肠外营养更能有效地对重症肺炎患者进行营养补充,提高其免疫功能,缩短有创机械通气时间,有效维持患者各组织器官功能。
Objective To study prognostic value of enteral and parenteral nutrition Methods for patients with severe pneumonia.Methods A total of 62 patients with severe pneumonia admitted during March 2016 and December 2017 were divided into control group and observation group(n=31 in each group)according to different nutritional supplementation Methods.Control group received parenteral nutrition,while observation group received enteral nutrition.After treatment,immune function,nutritional status,invasive mechanical ventilation time and incidence rate of complications were compared in two groups.Results After treatment,values of hemoglobin(HGB),albumin(ALB)and prealbumin(PAB)were significantly higher than those before treatment in two groups,and the values in observation group were significantly higher than those in control group(P<0.05).After treatment,values of IgG,IgA and IgM were significantly higher than those before treatment in two groups,and the values in observation group were significantly higher than those in control group(P<0.05).After treatment,levels of CD 4+/CD 8+and CD3+were significantly higher than those before treatment in two groups,and the levels in observation group were significantly higher than those in control group;CD 8+levels were significantly lower than those before treatment in two groups,and the level in observation group was significantly lower than that in control group(P<0.05).In observation group,invasive mechanical ventilation time was significantly shorter,while the incidence rate of ventilator-associated pneumonia(VAP)was significantly lower than those in control group(P<0.05).Incidence rates of aspiration,diarrhea,abdominal distension and gastric retention in observation group were significantly higher than those in control group(P<0.05),and there was no significant difference in incidence rate of dysmetabolism between two groups(P>0.05).Conclusion Compared with those by parenteral nutrition,early enteral nutrition may effectively provide nutritional supplement,improve immune function,shorten invasive mechanical ventilation time and effectively maintain functions of all organs of patients with severe pneumonia.
作者
李媛媛
张强
马岚
黄丁丁
LI Yuan-yuan;ZHANG Qiang;MA Lan;HUANG Ding-ding(Department of Critical Care Medicine,Weinan Central Hospital,Weinan,Shaanxi 714000,China)
出处
《解放军医药杂志》
CAS
2019年第8期49-52,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省社会发展科技攻关项目(2017SF-032)
关键词
重症肺炎
肠内营养
肠外营养
预后
Severe pneumonia
Enteral nutrition
Parenteral nutrition
Prognosis
