不同营养支持策略在慢性阻塞性肺病急性发作机械通气患者中的对比研究

目的探讨2种营养支持策略对慢性阻塞性肺病急性发作（AECOPD）行机械通气患者临床疗效的影响。方法收集AECOPD行机械通气患者40例，随机分为2组，研究组20例，对照组20例，在治疗原发病和生命支持的同时，研究组给予肠外营养（PN）＋肠内营养（EN），对照组单纯予以EN。对比2组患者治疗前后营养代谢、免疫指标的变化、带机时间及平均住院时间。结果治疗后研究组前自蛋白、转铁蛋白、尿素氮较对照组升高明显（P〈0．05）；研究组平均带机时间为6．2d，住院时间为21d；对照组平均带机时间为8．8d，住院时间为27d。2组比较差异有统计学意义（P〈0．05）。结论对AECOPD行机械通气的患者应积极给予营养支持，肠内加肠外营养有利于快速改善患者的营养状态，利于患者恢复，应首先选用。

Comparative study on effect of nutrional support using mechanical ventilation in treating AECOPD patients with mechanical ventilation

Objective To evaluate the effection of nutrional support treatment and the comparement of effects between those treatments in treating AECOPD patients with mechanical ventilation. Methods 40 AECOPD patients using mechanical ventilation were randomly divided into enteralnutrition group （EN）, parentaralnutrition and enteralnutrition group（ PN ＋ EN）, The change of every groups patients＇indexes, such as ALB,PA,BUN,IgA,IgM,IgG,and hospitalized time , ventilation duration were observed before and 12 days later after treatment. Results The indexes of ALB,PA,BUN in PN ＋ EN obviously higher than those in EN （ P 〈 0.05 ）. On the variables of hospitalized time, ventilation duration the group of PN ＋ EN was lower than the group of EN （P 〈 0.05）. Conclusion Nutritional supporting therapy is of great benefit to the AECOPD patients with mechanical ventilation. The treatment with parentaralnutrition and enteralnutrition has more advantage than that with enteral nutrition.