早期肠内营养对老年心衰合并营养不良患者心功能及预后的影响

目的：探讨早期肠内营养对营养不良老年心衰患者心功能及预后的影响。方法选择80例心力衰竭合并营养不良的老年患者，按照随机数字法分为观察组与对照组，每组40例。观察组进行早期的肠内营养支持，对照组进行常规饮食，比较两组治疗前后前白蛋白，转铁蛋白变化情况，及治疗后两组左室射血分数、体内炎症细胞因子变化及发生的并发症。结果观察组治疗后前白蛋白、转铁蛋白均高于治疗前及治疗后对照组(P<0．05)，治疗后观察组B型脑钠肽显著低于对照组(P<0．05)，左室射血分数高于对照组(P<0．05)。治疗过程中，观察组发生低钠血症、高钠血症、高血糖以及二重感染比例低于对照组(P<0．05)。结论对心衰合并营养不良的老年患者实施早期的肠内营养支持，在保证机体能量补充的同时，更好的维持电解质平衡，改善患者营养状况从而改善免疫功能，起到了综合治疗的目的。

Effects of early enteral nutrition on malnutrition for heart failure with heart function and prognosis of elderly

Objective To investigate the effect of early enteral nutrition on malnutrition for heart failure with heart function and prog-nosis in the elderly. Methods Eighty cases of heart failure together with malnutrition were chosen and randomized into the observation group and the control group, with 40 in each. The observation group used early enteral nutrition support, while the control group were treated with conventional diet, then albumin, transferrin changes before and after treatment were compared, and left ventricular ejection fraction complica-tions, changes in body cells and inflammatory cytokines occurs and sodium levels after treatment were compared. Results In the observation group after treatment with prealbumin, transferrin was higher than that before and after treatment of control group(P<0. 05);after treatment, BNP, CRP of the observation group were lower than those of control ( P<0. 05 ); left ventricular ejection fraction in the observation group was higher than that in the control (P<0. 05);hyponatremia, hypernatremia, hyperglycemia and superinfection ratio were lower than control group(P<0. 05). Conclusion To implement the early enteral nutrition support in malnourished elderly patients with heart failure can en-sure complement the body′s energy and better maintain electrolyte balance, and reduce the body′s inflammatory response, so it can improve the nutritional status and thus improve immune function, thus achieving the purpose of comprehensive treatment.