低糖高脂肠内联合肠外营养对机械通气COPD患者的疗效影响及经济学意义.docVIP

低糖高脂肠内联合肠外营养对机械通气COPD患者的疗效影响及经济学意义 王宏星 夏艳 邵少英 （南通大学第三附属医院临床营养科 无锡 214041） 摘要：目的 观察低糖高脂肪营养支持在机械通气COPD患者中的临床疗效。方法：将103例机械通气COPD患者随机分成三组：研究A组34例，研究B组36例，对照组33例。三组均予吸氧、抗感染、解痉平喘、化痰、纠正酸碱失衡及电解质紊乱等常规治疗。研究A组予低糖高脂EN联合传统PN；研究B组予低糖高脂EN联合低糖高脂PN；对照组予传统EN联合PN，疗程均为10天。在研究前1天、研究第10天分别对三组患者进行血气分析指标、呼吸功能状况测定；并对患者脱机时间、住院天数、住院总费用、营养支持费用等方面亦进行比较。结果：研究A和B两组在营养状况、血气分析指标、呼吸功能状况方面改善情况均较对照组有显著性差异（P0.05），而且研究B组比研究A组改善情况更明显（P0.05）；研究A和B两组在脱机时间、住院天数、住院总费用、营养支持费用均较对照组少（P0.05），而研究B组较研究A组更少（P0.05）。结论：低糖高脂肪肠内与肠外营养支持治疗较以往常规治疗及单纯低糖高脂肪肠内营养能更明显改善机械通气COPD患者的症状和体征，明显改善人体血气分析和肺功能，对纠正呼吸衰竭有良好疗效。 关键词： 肠内营养；低糖高脂；呼吸商；机械通气；慢性阻塞性肺病 Clinical effect and significance in economics of low carborhydrate and high fat paraenteral and enteral nutrient solution in improving chronic obstructive pulmonary disease patients under mechanical ventilation Wang hong-xing Xia yan Shao shao-ying （Department of Clinical Nutrition，affiliated No.3 Hospital，Nantong University，Wuxi 214041） Abstract Objective to evaluate clinical curative effects of low carborhydrate and high fat paraenteral and enteral nutrition in COPD patients complicated by respiratory failure. Methods 103 patients with COPD patients under mechanical ventilation were randomly divided into three groups . There are 34 people in treatment group A，there are 36 in treatment group B , and 33 in control group. Anti-infection,oxyen inhalation,spasmolysis and anti- asthma,eliminating phlegm,correcting acid-base inbalance and electrolyte disorder and so on were used in the three groups. The treatment group A were given low carborhydrate and high fat enteral nutrition support, adding traditional paraenteral nutrition support. The treatment group B were given low carborhydrate and high fat paraenteral and enteral nutrition support.While the control group were given traditional nutritional support for 10 days. When one day before and 10 days after the study, blood gas analysis index, respiratory function condition were determined in the three groups of patient