摘要
目的 观察瑞能营养液对重症机械通气(MV)患者营养指标、免疫功能和疾病转归的影响.方法 选择2015年1月至2016年12月杭州市萧山区第一人民医院收治的重症呼吸衰竭(衰竭)行MV治疗的84例患者为研究对象,按治疗方法不同分为观察组和对照组,每组42例.对照组给予纽健匀浆膳行肠内营养(EN)支持,观察组给予瑞能.观察两组血清营养指标、T淋巴细胞亚群、疾病转归、营养相关并发症等指标的变化.结果 两组治疗后血清白蛋白(ALB)、前白蛋白(PA)、血红蛋白(Hb)均较治疗前明显升高,且以观察组治疗后的升高程度较对照组更明显〔ALB(g/L):35.63±4.21比30.45±3.52,PA(mg/L):253.12±24.32比240.23±20.31,Hb(g/L):145.12±7.32比131.02±7.05,均P<0.05〕;两组治疗后CD4+、CD8+、CD4+/CD8+均较治疗前明显降低,但观察组治疗后CD4+、CD4+/CD8+比值均明显高于对照组(CD4+:0.41±0.03比0.36±0.02, CD4+/CD8+:1.46±0.20比1.30±0.18,均P<0.05).观察组MV时间(d:7.82±1.04比10.13±1.25)、重症加强治疗病房(ICU)住院时间(d:11.36±1.32比15.40±1.52)均较对照组明显缩短,呼吸机相关性肺炎(VAP)发生率〔11.90%(5/42)比33.33%(14/42)〕、病死率〔2.38%(1/42)比7.14%(3/42)〕和营养相关并发症发生率〔19.05%(8/42)比52.38%(22/42)〕均较对照组降低(均P<0.05).结论 瑞能营养液有助于缩短重症MV患者MV时间、ICU住院时间,减少EN相关性并发症发生率,其机制可能与改善患者营养状况、调节免疫功能有关.
Objective To explore the influence of Ruineng nutritional fluid on nutrition status, immunity and prognosis in severe patients with mechanical ventilation (MV). Methods Eighty-four patients with severe respiratory failure and MV admitted to Xiaoshan District First People's Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group and a control group according to the different methods of treatment, each group 42 cases. The patients in control group were given homogenate meat for enteral nutrition (EN) support, and those in observation group, given Ruineng nutritional fluid. The changes of serum nutrition indexes, T lymphocyte subgroups, disease outcomes, nutrition related complications, etc. indicators were observed before and after treatment in both groups. Results After treatment the levels of serum albumin (ALB), prealbumin (PA), hemoglobin (Hb) were significantly higher than those before treatment in both groups, and the degrees of increase after treatment of observation group were more obvious compared with those in the control group [ALB (g/L): 35.63±4.21 vs. 30.45±3.52, PA (mg/L): 253.12±24.32 vs. 240.23±20.31, Hb (g/L): 145.12±7.32 vs. 131.02±7.05, all P < 0.05]; after treatment, the levels of CD4+, CD8+and CD4+/CD8+were significantly lower than those before treatment in the two groups, but the levels of CD4+and CD4+/CD8+in observation group were significantly higher than those in the control group (CD4+: 0.41±0.03 vs. 0.36±0.02, CD4+/CD8+: 1.46±0.20 vs. 1.30±0.18, both P < 0.05). The time of MV (days: 7.82±1.04 vs. 10.13±1.25) and intensive care unit (ICU) hospital stay (days: 11.36±1.32 vs. 15.40±1.52) in observation group were significantly shorter than those in the control group, and the incidence of ventilator associated pneumonia [VAP: 11.90% (5/42) vs. 33.33% (14/42)], the fatality rate [2.38% (1/42) vs. 7.14% (3/42)] and the incidence of nutrition related complications [19.05% (8/42) vs. 52.38% (22/42)] were significantly lower in observation group than those in the control group. Conclusion Ruineng nutritional fluid can shorten the time of MV and ICU hospital stay, reduce the incidence of EN associated complications, that is possibly related to the improvement of patients' nutritional status and regulation of their immune function.
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第2期165-168,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
机械通气
Ω-3多不饱和脂肪酸
营养状况
免疫功能
Mechanical ventilation
ω-3 polyunsaturated fatty acids
Nutritional status
Immunological function
