营养支持对降低ICU肿瘤重症患者呼吸机相关性肺炎的临床效果

目的探讨营养支持对降低ICU肿瘤重症患者呼吸机相关性肺炎的临床效果。方法选取2018年6月至2019年9月间四川电子科技大学医学院附属肿瘤医院收治的90例行气管插管机械通气治疗的肿瘤重症患者,采用随机数字表法分为观察组47例和对照组43例。观察组患者采用早期肠内外营养支持,对照组患者采用常规营养支持,比较两组患者呼吸机相关性肺炎(VAP)发生率、住院时间、机械通气时间及21d致死率;比较两组患者入ICU第1天及治疗14d后淋巴细胞计数、血红蛋白、血清总蛋白及血清白蛋白水平。结果诊疗后,观察组患者淋巴细胞计数、血红蛋白、白蛋白及总蛋白水平均增加,且均大于对照组,对照组患者淋巴细胞计数升高,血红蛋白、白蛋白及总蛋白水平均下降,差异均有统计学意义(均P <0.05)。观察组患者VAP发病率、住院时间、机械通气时长与21天致死率均低于对照组,差异均有统计学意义(均P <0.05)。结论早期营养支持对降低ICU肿瘤重症患者VAP发病率效果较好,且可有效改善机体状况及预后。

Clinical efficacy of nutritional support for reduction of ventilator-associated pneumonia in critically ill patients with tumors

Objective To explore the clinical efficacy of nutritional support for reduction of ventilator-associated pneumonia in ICU patients with severe tumors. Methods A selection of 90 critically ill patients with tumors treated by mechanical ventilation with tracheal intubation at Cancer Hospital Affiliated to University of Electronic Science and Technology School of Medicine from June 2018 to September 2019 were selected. They were randomly divided into an observation group( 47 patients) and a control group( 43 patients). Patients in the observation group were given early enteral and parenteral nutritional support and the control group was given conventional nutritional support. The incidence of ventilator pneumonia( VAP),length of hospital stay,the duration of mechanical ventilation,and the 21 d mortality rate were compared between the two groups. The lymphocyte count,hemoglobin,overall serum protein and serum albumin were compared between the two groups within the first day of ICU admission and at 14 d after the treatment.Results The lymphocyte count,hemoglobin,overall serum protein and serum albumin were increased in the observation group and were higher than in the control group and lymphocyte count was increased and hemoglobin,overall serum protein and serum albumin were decreased in the control group( all P < 0. 05).The incidence of VAP,length of hospital stay,duration of mechanical ventilation,and 21 d mortality were lower in the observation group than in the control group( all P < 0. 05). Conclusion Early nutritional support has a significant effect on reducing the incidence of VAP in critically ill patients with tumors,and can effectively improve the physical condition and prognosis.