早期肠内营养支持对ARDS患者的免疫功能影响

目的观察早期肠内营养支持对ARDS患者的免疫功能影响以及对最终死亡率的影响.方法ARDS患者在开始机械通气分为肠内营养组和对照组,肠内营养组在机械通气当天即通过鼻胃管或鼻肠管给予鼻饲合成营养素,对照组则延迟至7天以后应用肠内营养.然后统计各项指标情况.结果治疗两周后及存活者出院时观察组与对照组相比在总蛋白、淋巴细胞数量、以及CD3和CD4水平均有明显升高,而CD8变化不大.肠内营养组与对照组相比在机械通气时间(平均12.8±2.1天、17.6±3.6天)、住ICU时间(平均21.5±4.6天、31.5±3.4天)均明显缩短.两组最终病死率有明显差异,肠内营养组为27.8%,对照组为35.7%.两组营养支持相关并发症发生率无明显差异.结论早期肠内营养支持可提高ARDS患者的免疫功能,提高总蛋白水平,降低最终病死率,缩短机械通气时间和住ICU时间,从而降低患者的医疗费用.

Effect of Early Enteral Nutrition Support on Immune Function in Patients with Acute Respiratory Distress Syndrome

] Objective To investigate the effect of early enteral nutrition support on immune function and mortality in patients with Acute Respiratory Distress Syndrome (ARDS). Methods When mechanical ventilation began, the patients with ARDS were divided into two groups: the enteral nutrition group (EN group) and the control. In EN group patients were given enteral feeding by nasogastric tube or nasointestinal tube on that day mechanical ventilation began, whereas in the control group enteral feeding was supplied 7 days later. Then collect and analyze the related data. Results Compared with the control group, the total protein, quantity of lymph cell and the level of CD3, CD4 increased significantly in the survival cases in EN group after two weeks treatment or at discharge, while the time of ventilation and staying in ICU decreased significantly, but CD8 was not different between the two groups. The mortality in the two groups was 27.8% and 35.7% respectively, which existed significant difference. However, there was no significant difference in the incidence of the complications associated with nutrition support between two groups. Conclusions Early enternal nutrition can improve the immune function of patients with ARDS, raise total protein, decrease mortality and the time of ventilation and staying in ICU, so as to reduce the treat cost.