摘要
目的观察鼻饲营养辅助治疗对卒中相关性肺炎(SAP)的临床疗效。方法选取2017年5月至2018年5月首都医科大学附属复兴医院呼吸内科收治的178例SAP患者为研究对象,根据辅助营养支持治疗方法不同分为对照组(130例)和研究组(48例),对照组采用经口进食营养支持,研究组采用经鼻饲辅助营养支持。比较两组抗感染治疗效果、治疗前后血清白蛋白水平、治疗后血清白蛋白改善率、再感染率、抗菌药物使用时间、使用强度以及住院时间、住院费用及不良反应发生情况。结果研究组抗感染治疗总有效率明显高于对照组[97.9%(47/48)比84.6%(110/130)](P<0.05)。治疗前后血清白蛋白水平的主效应差异无统计学意义(P>0.05);不考虑测量时间,两组间血清白蛋白水平的主效应差异有统计学意义(P<0.05);血清白蛋白水平的时点间与组间不存在交互作用(P>0.05)。研究组血清白蛋白改善率明显高于对照组[60.4%(29/48)比32.3%(42/130)](P<0.01),且研究组再感染率明显低于对照组[12.8%(6/47)比50.0%(55/110)](P<0.001)。研究组抗菌药物使用时间、使用强度以及住院时间、住院费用均低于对照组[9(7,11)d比10,(7,15)d,11(8,15)DDD比15(9,23)DDD,11(9,14)d比15(10,21)d,1.69(1.28,2.24)万元比1.97(1.34,3.33)万元](P<0.05或P<0.01)。两组治疗过程中均未出现出血、神经损伤、恶性心律失常等严重不良反应。研究组鼻咽部疼痛3例、恶心等轻微不适经对症治疗后缓解。结论鼻饲营养辅助治疗SAP的抗感染治疗总有效率较高,且患者营养状态改善,肺部再感染发生率、抗菌药物使用时间及强度均降低,住院时间缩短及住院费用减少,无严重不良反应发生。
Objective To observe the effect of nasal feeding nutrition on stroke-associated pneumonia(SAP).Methods 178 cases of SAP treated in Department of Respiratory Medicine,Fuxing Hospital,Capital Medical University from May 2017 to May 2018 were included in the study,and were divided into a control group(130 cases,oral nutrition support)and a study group(48 cases,nasal nutrition support)according to the nutrition support method.The anti-infective effect,serum albumin before and after treatment,serum albumin improvement rate,reinfection rate,antimicrobial use time and intensity,hospitalization time and cost,and adverse reactions were observed and compared between the two groups.Results The total effective rate of anti-infection treatment in the study group was significantly higher than that in the control group[97.9%(47/48)vs 84.6%(110/130)](P<0.05).There was no significant difference in the main effect of serum albumin level before and after treatment(P>0.05);regardless of the measurement time,the main effect difference of serum albumin level between the two groups was statistically significant(P<0.05);there was no interaction in serum albumin level between time points and groups(P>0.05).The improvement rate of serum albumin in the study group was significantly higher than that in the control group[60.4%(29/48)vs 32.3%(42/130)](P<0.01),and the reinfection rate in the study group was significantly lower than that in the control group[12.8%(6/47)vs 50.0%(55/110)](P<0.001).The antimicrobial use time andintensity,length of stay and expenses of hospitalization of the study group were lower than those of the control group[9(7,11)d vs 10(7,15)d,11(8,15)DDD vs 15(9,23)DDD,11(9,14)d vs 15(10,21)d,1.69(12.8,22.4)k Yuan vs 19.7(13.4,33.3)k Yuan](P<0.05 or P<0.01).There were no serious adverse reactions such as bleeding,nerve injury,malignant arrhythmia in both groups.In the study group,there were 3 cases of nasopharynx pain and nausea,which were relieved after symptomatic treatment.Conclusion The total effective rate of nasogastr
作者
呼玮
陈谨
HU Wei;CHEN Jin(Department of Respiratory Medicine,Fuxing Hospital,Capital Medical University,Beijing 100038,China)
出处
《医学综述》
2021年第4期809-812,共4页
Medical Recapitulate
关键词
卒中相关性肺炎
鼻饲
肠内营养
Stroke-associated pneumonia
Nasal feeding
Enteral nutrition
