摘要
目的:探讨对营养不良慢性阻塞性肺疾病的患者采用强化肠内营养治疗的疗效。方法:选择2009年1月—2011年11月在我院住院经确诊为营养不良的慢性阻塞性肺疾病(COPD)患者103例,按随机区组设计随机分为2组。一组为强化治疗组,共49例,按热量25～30 kcal·kg-1·d-1给予肠内营养乳剂,同时给予谷氨酰胺颗粒0.5 kg-1·g-1·d-1以及双歧杆菌四联活菌片6 g强化治疗,另一组为对照组54例,仅按热量25～30 kcal·kg-1·d-1给予常规的肠内营养乳剂。其余治疗相同,随访30 d。比较2组平均每天热量摄入和蛋白质摄入量、营养治疗后5 d前后握力,营养治疗14 d前后的淋巴细胞计数、前白蛋白、PaO2和PaCO2、APACHEⅡ评分、呼吸机使用时间、营养治疗期间腹泻发生率、28 d的死亡率。结果:热量摄入和蛋白质摄入量无差异的前提下,强化治疗组治疗后5 d后握力,治疗14 d后的淋巴细胞计数、前白蛋白、PaO2和PaCO2、APACHEⅡ评分以及呼吸机使用时间、营养治疗期间腹泻发生率、28 d的死亡率都优于对照组。结论:采用Gln、益生菌强化肠内营养治疗可改善COPD患者营养状况和肺功能,延缓呼吸肌疲劳或恢复呼吸肌功能,降低死亡率和肠内营养治疗期间的腹泻发生率,从而提高患者的治疗效果。
OBJECTIVE To explore the therapeutic effect of strengthening enteral nutrition treatment in the cacotrophy chronic obstructive pulmonary disease（COPD） patients.METHODS 103 Cases of cacotrophy COPD hospitalized patients from January,2009 to November,2011 in our hospital were selected and randomly divided into two groups： one group（n=49） was given with enteral nutrition emulsion according to caloric 25-30 kcal·kg-1·d-1 and simultaneously receiving glutamine granules 0.5 kg-1·g-1·d-1 as well as Bifidobacterium Tetravaccine tablets 6 g strengthening treatment;another group（the control group,n=54）,only receiving caloric 25-30 kcal·kg-1·d-1 enteral nutrition emulsion,other treatments was the same,taking a follow-up visit for 30 days.The average daily amount of caloric and protein intake,the power of gripping before and after 5 d treatment,lymphocyte count before and after 14 d nutritional therapy,prealbumin,PaO2 and PaCO2,APACHE Ⅱ score,the period of using breathing machine,the rate of diarrhoea in nutritional therapy period,28 day-long mortality were compared between the two groups.RESULTS Under the amount of caloric and protein intake was non-difference premise,the power of gripping after 5 d treatment,lymphocyte count after 14 d nutritional therapy,prealbumin,PaO2 and PaCO2,APACHE Ⅱ score,the period of using breathing machine,the rate of diarrhoea in nutritional therapy period,28 day-long mortality of the strengthened treatment group all surpassed the control group.CONCLUSION Using glutamine,probiotics to strengthen the enteral nutrition treatment can improve the nutriture and lung function of COPD patients,delay the respiratory muscle weariness and restore respiratory muscle function,reduce mortality and the rate of diarrhoea in nutritional therapy period and improve the therapeutic effect.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2012年第19期1556-1558,共3页
Chinese Journal of Hospital Pharmacy
基金
广西卫生厅立项课题(编号:Z2008466)
