摘要
目的:评价早期肠内营养(EN)方式对脓毒症病人机械通气治疗脱机的影响。方法:将64例确诊为脓毒症病人行机械通气者随机分为24 h内EN治疗(A组,n=32)和72 h后EN治疗(B组,n=32)。在常规综合治疗的基础上,A组24于h内给予EN和肠外营养(PN)治疗;B组于72 h内给予TPN治疗,72 h后加用EN,两组病人接受等氮、等热量营养支持。比较两组不同时机加用EN支持1周后的营养状况、临床有效率、脱机成功率以及28 d病死率等。结果:两组病人营养支持及综合治疗后有效率无显著性差异(P>0.05),但血清清蛋白、前清蛋白和总蛋白、淋巴细胞计数水平有所升高,其中A组明显高于B组(P<0.05)。同时,两组病人治疗后氧合指数、呼吸浅快指数、口腔闭合压、肺动态顺应性均明显好于治疗前(P<0.05),组间氧合指数和病死率无统计学差异(P>0.05)。而A组呼吸浅快指数、口腔闭合压、肺动态顺应性与B组比较有显著性差异(P<0.05),A组脱机成功率明显高于B组(P<0.05)。结论:EEN支持可提高脓毒症病人的营养状态,有利于肠功能恢复,缩短病人机械通气时间,提高脱机成功率。
Objective： To evaluate the effect of early enteral nutrition on sepsis patients with mechanical ventilation treatment. Methods： 64 patients with diagnosis of sepsis patients who need mechanical ventilation patients were randomly divided into group A： receivingenteral nutrition （EN） within 24 hours （32 cases） and group B ：receivingenteral nutrition （EN）72 hours later （32 cases）. On the basis of routine comprehensive treatment, providing group A patients withnutrition （EN） and parenter- al nutrition （PN） in 24 hours and Providing group B patients withtotal parenteral nutrition in 72 hours and enteral nutrition （EN） 72 hours later. The heat and nitrogen of thenutrition support in the two groups are equal. After one week, Compare the nutritional status, clinical effectiveness, withdraw machine suc-cess rate and 28 days-mortality. In the two groups. Results： The efficiency of nutritional support and comprehensive treatment has no obvious difference in two groups of patients （ P 〉 0.05 ）, but serum albumin, prealbumin and total protein, lymphocyte count of the group A patients were significantly higher than group B. （ P 〈 0.05 ）, afternutrition support, oxygenation index, shallow breathing fast index, mouth closed the dynamic pressure, and pulmonary compliance of all patients in the two groups were improved significantly （P 〈 0. 05 ）, but the oxygenation index and mortality is no statistical difference between groups （ P 〉 0.05 ）, while breathing shallow fast index, oral cavity closure pressure, the dynamic lung compliance had significant difference （P 〈 0.05 ）, withdraw machine success rate weaning success rate of group A is significantly higher than group B （P 〈 0. 05）. Conclusion： Early nutrition support can improve nutritional status of sepsis patients, and is helpful to the early recovery of intestinal function, reduce the time of mechanical ventilation. Besides early nutrition can obviously improvewithdraw machine success rate.
出处
《肠外与肠内营养》
北大核心
2016年第4期216-219,共4页
Parenteral & Enteral Nutrition
关键词
早期肠内营养
脓毒症
机械通气
脱机
The early enteral nutrition
Sepsis
Mechanical ventilation
Weaning of ventilator
