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目的:探讨重症营养喂养流程对慢性阻塞性肺疾病急性加重（AECOPD）并呼吸衰竭行机械通气患者营养状态、炎症指标及心肺功能的影响。方法:前瞻性选择2017年12月至2020年1月本院重症医学科诊断为AECOPD并发呼吸衰竭需行机械通气的患者60例，按随机数字表法将患者分为A、B两组，每组30例，A组行常规早期肠内营养（EN），B组根据重症营养喂养流程实施早期EN，比较两组患者营养支持前及营养支持后2周营养状况、炎症指标、心肺功能变化，2组患者机械通气时间、ICU入住时间。结果:营养支持2周后，B组血清总蛋白（TP）、白蛋白（ALB）、前白蛋白（PA）、血红蛋白（HB）增加幅度分别为（9.91±0.60）g/L、（7.6±0.58）g/L、（30.07±4.65）mg/L、（15.43±1.18）g/L明显高于A组（5.69±0.80）g/L、（4.20±0.47）g/L、（15.97±3.05）mg/L、（6.70±0.49）g/L，两组间比较差异具有统计学意义（n P<0.05）。B组超敏C反应蛋白（hs-CRP）、降钙素原（PCT）、血浆乳酸（LA）降低幅度分别为（39.07±5.55）mg/L、（1.24±0.22）ng/L、（1.11±0.13）mmol/L明显高于A组（18.94±3.18）mg/L、（0.58±0.17）ng/L、（0.70±0.09）mmol/L，两组间比较差异具有统计学意义（n P0.05）。B组患者气管插管前及拔除气管插管后24 h血氧分压（PaOn 2）、氧合指数（动脉氧分压（PaOn 2）/吸入氧分数（FiOn 2））升高幅度分别为（25.17±1.71）mmHg、（231.53±5.39）%明显高于A组（12.17±1.59）mmHg、（164.60±5.66）%，B组血二氧化碳分压（PaCOn 2）降低幅度（25.26±1.66）mmHg明显高于A组（20.11±1.08）mmHg，两组间比较差异具有统计学意义（n P<0.05）。B组机械通气时间、ICU入住天数分别为（10.17±0.46）d、（15.70±0.23）d低于A组（12.30± 0.64）、（17.93±0.52）d，两组间比较差异具有统计学意义（n P<0.05）。n 结论:与常规早期肠内喂养相比，AECOPD合并呼吸衰竭行机械通气患者采用基于重症患者喂养流程的早期肠内营养可提高患者的营养状态，降低炎性因子水平并减轻炎性反应，缩短机械通气时间、ICU入住时间。“,”Objective:To investigate the effects of enteral nutrition feeding process in critically ill patients on nutritional status, inflammation indexes and cardiopulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure with mechanical ventilation.Methods:From December 2017 to January 2020, 60 patients who were diagnosed with AECOPD complicated with respiratory failure requiring mechanical ventilation were selected from the Department of Intensive Medicine of our hospital. The patients were divided into group A and group B according to the random number table method. Group A underwent conventional early enteral nutrition (EN) treatment, group B implemented early EN according to the enteral nutrition feeding process. The nutritional status, inflammation indicators, cardiopulmonary function, mechanical ventilation time and length of ICU stay before and after nutritional support between the two groups were comparedResults:After 2 weeks of nutritional support, the serum total protein (TP), albumin (ALB), prealbumin (PA) and hemoglobin (HB) in group B were increased by [(9.91±0.60)g/L, (7.6±0.58)g/L, (30.07±4.65)mg/L, and (15.43±1.18)g/L, which were significantly higher than those in group A (5.69±0.80)g/L, (4.20±0.47)g/L, (15.97±3.05)mg/L, and (6.70±0.49)g/L, respectively], and the difference between the two groups was statistically significant (n P<0.05). The high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and plasma lactic acid (LA) in group B were decreased by 39.07±5.55, 1.24±0.22, and 1.11±0.13, which were significantly higher than those in group A (18.94±3.18, 0.58±0.17 and 0.70±0.09, respectively), and the difference between the two groups was statistically significant (n P0.05). The blood oxygen partial pressure (PaOn 2) and PaOn 2/ inhaled oxygen fraction (FiOn 2) of group B before tracheal intubation and 24 h after tracheal intubation were increased by (25.17±1.71) mmHg and (231.53±5.39)%, which were significantly higher than those of group A [(12.17±1.59) mmHg and (164.60±5.66)%, respectively]. The blood carbon dioxide partial pressure (PaCOn 2) in group B was decreased by (25.26±1.66)mmHg, which was significantly higher than that in group A (20.11±1.08) mmHg, and the difference between the two groups was statistically significant (n P<0.05). The mechanical ventilation time and length of ICU stay in group B were significantly lower than those in group A (10.17±0.46) d n vs (12.30±0.64) d, (15.70±0.23) d n vs (17.93±0.52) d, all n P<0.05).n Conclusion:When compared with conventional early enteral feeding, early enteral nutrition based on the enteral nutrition feeding process in AECOPD with respiratory failure and mechanical ventilation patients can improve the nutritional status, reduce the level of inflammatory indicators and the inflammatory response, and shorten the mechanical ventilation time and length of ICU stay.