早期肠内营养在COPD病人营养支持中的临床价值

目的探讨早期肠内营养在重症COPD患者中的临床应用。方法回顾性分析我院2008年2月-2010年12月收治入院的28例重症COPD患者临床资料,随机将28例患者分为两组,观察组14例应用早期肠内营养,对照组14例采用进口进食半流质。能量均为1000kcal/d。观察两组患者面罩无创通气时间,无创应用时间,住院时间,住院费用等指标。结果营养组患者28天死亡率均为4/14,传统组28天死亡率为4/14d。无明显差异。两组患者存活组中,营养组平均无创通气时间为165±24 h,传统组为245±29 h,有显著差异。营养组住院时间为19±4.6d,传统组为26±4.4d,有显著差异。尽管应用肠内营养,但是肠内营养组治疗费用为11227±1834.3元,传统组为16384±2086.3元,明显降低医疗费用。观察组PaO2（10.74±0.82）kPa、PaCO2（6.29±0.75）kPa;对照组PaO2（8.59±0.88）kPa、PaCO2（7.64±0.81）kPa,两组比较差异有统计学意义,P〈0.05。结论尽管不能降低死亡率,但是肠内营养仍然值得在重型COPD患者治疗中推广。

Early Enteral Nutrition in COPD Patients in The Clinical Value of Nutritional Support

【Objective】 To investigate the early enteral nutrition in critically ill patients with COPD in clinical application.【Methods】 A retrospective analysis of our hospital in February 2008-2010 December 28 admitted to hospital clinical data of patients with severe COPD patients,28 patients were randomly divided into two groups to observe the group of 14 patients with early enteral nutrition in the control group 14 patients with eating imported semi-liquid.Energy are 1000kcal / day.Observed in patients with non-invasive ventilation mask,non-invasive application time,hospital stay,hospital costs and other indicators.【Results】 The nutrition group were 28-day mortality of 4 / 14,the traditional group,28-day mortality was 4 / 14 days.No significant difference.Survival group,two groups of patients,nutrition,non-invasive ventilation group,the average time 165 ± 24 h,the traditional group 245 ± 29 h,there are significant differences.Nutrition group hospital stay 19 ± 4.6 days,the traditional group,26 ± 4.4 days,there are significant differences.Although enteral nutrition,enteral nutrition group,but the cost of treatment of 11227 ± 1834.3 yuan,the traditional group 16384 ± 2086.3 yuan,significantly lower medical costs.Observation group PaO2（10.74 ± 0.82） kPa,PaCO2（6.29 ± 0.75） kPa;control group PaO2（8.59 ± 0.88） kPa,PaCO2（7.64 ± 0.81） kPa,the difference was statistically significant,P 0.05.【Conclusion】 Although not reduce mortality,but still worthy of enteral nutrition in severe COPD patients in the promotion.