摘要
目的探讨高能量密度营养乳剂的肠内营养对重症肺结核机械通气患者的临床疗效。方法选取60例因呼吸衰竭行机械通气肺结核合并COPD患者,随机分为两组,每组30例。分别使用高能量密度营养乳剂(瑞高)(实验组,R组)和普通营养液(能全力)(对照组,N组),监测机械通气治疗后1天,第7天病人动脉血二氧化碳分压(PaCO2),外周血淋巴细胞计数(TLC),免疫球蛋白,血清前白蛋白(PA),甘油三酯(TC),总胆固醇(TG)。观察二氧化碳生成量(VCO2),每分钟通气量(VE),收集24小时尿液,测定尿总氮并每天计算氮平衡。结果治疗后,实验组分钟通气量,二氧化碳生成量(VCO2),血气二氧化碳分压较对照组明显改善(P<0.01),血清前白蛋白,甘油三酯,TG较对照组明显改善(P<0.05)。机械通气时间亦短于对照组(P<0.05),尿总氮较对照组明显减少(P<0.05)。免疫球蛋白,总淋巴细胞计数无明显改善改善(P>0.05)。结论因重症肺结核而行机械通气患者应用高能量密度营养乳剂的肠内营养支持治疗,可以有效缩短机械通气时间,改善预后。
Objective To investigate the clinical curative effect of enteral nutrition of high-energy density nutrition emulsions in the treatment of pulmonary tuberculosis patients with mechanical ventilation.Methods 60 patients were randomly and evenly divided into two groups.The test group was given high-energy density enteral nutritional solution and the control group was given ordinary enteral nutritional solution.The levels of PaCO2,TLC,immune globulin,serum prealbumin,triglyceride,and total cholesterol were detected at the 1st and 7th days after mechanical ventilation.Carbon dioxide production,minute-ventilation,and total nitrogen in urine of 24 hours were observed and calculated.Results The improvement of all the above mentioned indexes,except immune globulin and TLC,were more pronounced in the test group than in the control group（P0.05）.Conclusion The application of high-energy density enteral nutrition emulsions can shorten the duration of mechanical ventilation and improve the prognosis in the treatment of pulmonary tuberculosis patients with mechanical ventilation.
出处
《临床肺科杂志》
2013年第5期780-782,共3页
Journal of Clinical Pulmonary Medicine
基金
河北省卫生厅科研基金支持指令计划(20120027)
关键词
重症肺结核
高能量密度肠内营养乳剂
机械通气
疗效
severe pulmonary tuberculosis
high-energy density nutrition emulsions
mechanical ventilation
curative effect
