营养支持在治疗慢性阻塞性肺疾病合并呼吸衰竭中的应用(1)
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【摘要】 目的 观察不同途径营养支持在治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者中的作用。 方法 选取呼吸内科住院的COPD合并呼吸衰竭患者87例,随机分为肠内营养组(n=43)和静脉营养组(n=44),分别给予相同热量和氮量的肠内或肠外营养制剂。对比营养指标变化、病死率、不良反应等。 结果 两组间的营养指标(白蛋白、前白蛋白)比较差异有统计学意义(P<0.05或0.01),肠内营养组血红蛋白较静脉营养组增高，病死率较静脉营养组减低，但差异无统计学意义 (P>0.05)。结论 COPD合并呼吸衰竭的患者如胃肠道功能完整首选肠内营养支持，可明显改善危重患者的营养状况，提高治疗的综合效果。
【关键词】 慢性阻塞性肺疾病；呼吸衰竭；营养支持；肠内营养
文章编号：1003-1383(2010)02-0138-03 中图分类号：R 563.05 文献标识码：A
doi:10.3969/j.issn.1003-1383.2010.02.009
Nutrition support in the treatment of chronic obstructive pulmonary disease with respiratory failure
HUANG WeiJian
(Department of Respiratory,the People's Hospital of Tiandong,Tiandong Guangxi 531500)
【Abstract】 Objective To evaluate the effect of different ways nutrition support in the treatment of chronic obstructive pulmonary disease(COPD)with respiratory failure patients.
Methods Select 87 COPD patients combined with respiratory failure in the department of respiratory medicine，randomly divided into enteral nutrition group,parenteral nutrition group,both given the same heat and nitrogen enteral or parenteral nutrition preparation.Then compared nutrition index changing,mortality,adverse reactions in two groups.Results There was statistically significant difference between two groups by nutrition index(albumin,prealbumin)(P<0.05 or 0.01).The hemoglobin in the enternal nutrition group was higher than that in the parenteral nutrition group,and the mortalityin the enternal nutrition group was lower than that in the parenteral nutrition group,but there was no statistically significant difference between two groups(P>0.05).Conclusion Patients of COPD combined with respiratory failure should apply enternal nutrition support if they have a complete gastrointestinal function,enteral nutrition support can improve the nutritional status of critically ill patients,thereby enhancing the combined effect of the treatment.
【Key words】 chronic obstructive pulmonary disease;respiratory failure;nutritional support;enteral nutrition
慢性阻塞性肺疾病(COPD)合并呼吸衰竭是呼吸内科常见的重症疾病之一。文献报道营养不良的发生率可高达60%[1]，是COPD合并呼吸衰竭病人死亡的重要原因。近年来，营养支持治疗逐渐受到临床医生的重视，改善营养状况成为治疗COPD合并呼吸衰竭病人的重要方法之一 ......
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