摘要
目的探究基于重症喂养流程的早期肠内营养(EEN)管理对慢性阻塞性肺疾病急性加重(AECOPD)机械通气患者营养状态、胃肠道耐受性的影响。方法采用类实验研究方法, 按照入院时间先后顺序分组, 选择六安市中医院2020年1月至2021年6月住院治疗的AECOPD机械通气患者30例为对照组, 选择2021年7月至2022年12月的AECOPD机械通气患者30例为观察组。对照组采用常规EEN干预方法, 观察组采用基于重症喂养流程的EEN管理干预方法。比较干预后2组患者7 d内热量摄入量及蛋白摄入量, 记录患者胃肠道耐受情况及预后情况, 比较2组患者干预前及干预第7天的血红蛋白、白蛋白、前白蛋白水平。结果对照组男17例, 女13例, 年龄(66.37 ± 6.09)岁;观察组男16例, 女14例, 年龄(65.49 ± 6.35)岁。干预后, 观察组患者7 d内热量摄入量及蛋白摄入量分别为(3 513.62 ± 94.56)kJ/d、(51.06 ± 5.03)g/d, 均高于对照组的(2 859.41 ± 87.23)kJ/d、(36.78 ± 3.14)g/d, 差异均有统计学意义(t=27.85、13.19, 均P<0.05);干预前2组患者的白蛋白、血红蛋白、前白蛋白水平比较差异均无统计学意义(均P>0.05);干预后观察组的白蛋白、血红蛋白、前白蛋白水平分别为(37.16 ± 3.42)、(135.43 ± 12.64)g/L和(218.54 ± 15.38)mg/L, 均高于对照组的(34.25 ± 4.01)、(127.51 ± 11.12)g/L和(201.33 ± 15.04)mg/L, 差异均有统计学意义(t=3.02、2.58、4.38, 均P<0.05);观察组的反流误吸、肠营养中断率均为6.67%(2/30), 低于对照组的26.67%(8/30)和30.00%(9/30), 差异均有统计学意义(χ^(2)=4.32、5.46, 均P<0.05);观察组的机械通气时间、ICU入住时间分别为(7.62 ± 1.35)、(11.17 ± 2.04)d, 均短于对照组的(8.57 ± 1.01)、(12.83 ± 2.19)d, 差异均有统计学意义(t=3.09、3.04, 均P<0.05)。结论基于重症喂养流程的EEN管理干预能够改善AECOPD机械通气患者的营养状态, 提高其胃肠道耐受情况, 改善预后。
Objective To explore the effects of early enteral nutrition(EEN)management based on severe feeding process on nutritional status and gastrointestinal tolerance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)after mechanical ventilation.Methods In the quasi trial study,30 patients with AECOPD undergoing mechanical ventilation between January 2020 and June 2021 and other 30 patients undergoing mechanical ventilation between July 2021 and December 2022 in Liu′an Hospital of Traditional Chinese Medicine were enrolled as control group and observation group,respectively.The control group was given routine EEN intervention,while the observation group was given EEN management based on severe feeding process.The intakes of calorie and proteins within 7 d after intervention were compared between the two groups.The gastrointestinal tolerance and prognosis were recorded.The levels of hemoglobin,albumin and prealbumin were compared between the two groups before intervention and at 7 d after intervention.Results In the control group,there were 17 males and 13 females,with age of(66.37±6.09)years old.In the observation group,there were 16 males and 14 females,with age of(65.49±6.35)years old.After intervention,intakes of calorie and proteins within 7 d in the observation group were(3513.62±94.56)kJ/d and(51.06±5.03)g/d,more than those in the control group(2859.41±87.23)kJ/d,(36.78±3.14)g/d,the differences were statistically significant(t=27.85,13.19,both P<0.05).There were no significant difference in the levels of hemoglobin,albumin and prealbumin before intervention between the two groups(all P>0.05).After intervention,levels of albumin,hemoglobin and prealbumin were(37.16±3.42),(135.43±12.64)g/L and(218.54±15.38)mg/L in the observation group,higher than those in the control group(34.25±4.01),(127.51±11.12)g/L and(201.33±15.04)mg/L,the differences were statistically significant(t=3.02,2.58,4.38,all P<0.05).The incidence rates of reflux aspiration and enteral nutrition interru
作者
韩婷
佘会
Han Ting;She Hui(The First Department of Respiratory Medicine,Liu′an Hospital of Traditional Chinese Medicine,Liu′an 237000,China;Department of Nursing,Liu′an Hospital of Traditional Chinese Medicine,Liu′an 237000,China)
出处
《中国实用护理杂志》
2024年第5期344-349,共6页
Chinese Journal of Practical Nursing
关键词
肺疾病
慢性阻塞性
急性加重期
早期肠内营养
重症喂养流程
营养状态
胃肠道耐受性
Pulmonary disease,chronic obstructive
Acute exacerbation
Early enteral nutrition
Severe feeding process
Nutritional status
Gastrointestinal tolerance
