摘要
目的:评价肠内营养(EN)支持对呼吸机相关性肺炎(VAP)患者预后的影响。方法:将60例确诊为VAP的患者随机分为EN组(30例)和对照组(30例)。EN组患者接受等氮等热量营养支持,对照组仅给予普通饮食。两组给予相同的治疗方案。检测所有患者入组后第1、7、14天血清血红蛋白、总蛋白、白蛋白及前白蛋白等营养指标,观察记录患者的机械通气时间及脱机成功率。结果:入组后两组患者血清血红蛋白水平变化不大,组间差异无统计学意义(F时间=0.339,F组间=1.030,P>0.05);血清总蛋白、白蛋白及前白蛋白水平均随时间的推移而有所上升(F时间=23.868、8.528、6.613,P<0.01),血清总蛋白水平组间差异无统计学意义(F组间=0.491,P=0.486),而EN组血清白蛋白、前白蛋白水平均高于对照组(F组间=24.880、7.554,P<0.01)。EN组机械通气时间为(7.6±0.8)d,短于对照组的(10.3±1.0)d(t=13.279,P<0.001)。机械通气治疗2周内EN组脱机成功率为66.7%,明显高于对照组的36.7%(χ2=5.406,P=0.020)。结论:EN可以显著提高VAP患者的营养状况,改善预后。
Aim：To observe the effect of enternal nutrition （ EN） support on prognosis of patients with ventilator-asso-ciated pneumonia（VAP）.Methods： A total of 60 VAP patients were randomly divided into EN group and normal diet group,30 in each group.Serum hemoglobin,total protein,album and prealbum levels of the patients were detected on Day 1, 7 and 14 during the trial,and the weaning time and offline success rate were observed .Results： The serum hemoglobin levels of the two groups did not change much （Ftime =0.339, Fgroup =1.030, P＆gt;0.05）;the serum total protein, albumin, and prealbumin levels increased with time （Ftime =23.868,8.528,6.613,P＆lt;0.01）, and there was no significant differ-ence in the total protein level between the two groups （Fgroup =0.491, P=0.486）, while the albumin and prealbumin lev-els of EN group were higher than those of normal diet group （Fgroup =24.880, 7.554,P＆lt;0.01）.The weaning time of EN group was （7.6 ＆#177;0.8） d,shorter than （10.3 ＆#177;1.0） d of the normal diet group（t=13.279,P＆lt;0.001）;offline success rate within 2 weeks of EN group was 66.7%,higher than 36.7% of normal diet group（χ2 =5.406,P=0.020）.Conclu-sion：EN can enhance the nutritional status of patients with VAP and improve the prognosis .
出处
《郑州大学学报（医学版）》
CAS
北大核心
2014年第1期77-79,共3页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省卫生厅科技攻关项目201203032
郑州市科技局基金资助项目0910SGYS33389-13
关键词
呼吸机相关性肺炎
营养支持
肠内营养
ventilator-associated pneumonia
nutrition support
enternal nutrition
