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目的观察合理使用营养支持疗法后慢性肺心病急性加重并呼吸衰竭患者的近期疗效。方法慢性肺心病急性加重并呼吸衰竭病人45例,随机分成两组,对照组(n=23例)采用病员标准饮食,营养支持组(n=22例)在此基础上加用营养支持疗法。比较两组患者体重、营养指标、免疫功能、血气分析指标、治疗效果、住院时间及无创呼吸机脱机时间的差异。结果两组患者体重无明显变化;营养支持组前白蛋白、肌酐身高指数(CHI)及淋巴细胞总数(TLC)、IgA 较对照组升高更为明显(P<0.05);营养支持组 PaO_2升高和 PaCO_2下降较对照组更为明显(P<0.05);营养支持组治疗好转率为86.4%(19/22),平均达到治疗好转的住院时间为15.8±4.25 d;对照组患者治疗好转率为73.9%(17/23),平均达到治疗好转的住院时间为20.6±3.61 d,两组比较有显著性的差异(P<0.05);营养支持组无创呼吸机脱机时间较对照组明显缩短(P<0.05)。结论合理的营养疗法在慢性肺心病急性加重并呼吸衰竭治疗中有重要意义。
Objective To observe the short-term curative effect of patients with acute exacerbation of chronic pulmonary heart disease and respiratory failure after rational use of nutritional supportive therapy. Methods Forty-five patients with acute exacerbation of chronic pulmonary heart disease and respiratory failure were randomly divided into two groups. The control group (n = 23) received nutritional support therapy on the basis of the standard diet and nutrition support group (n = 22). The differences of body weight, nutritional index, immune function, blood gas analysis index, treatment effect, hospitalization time and noninvasive ventilator offline time were compared between the two groups. Results There was no significant change in body weight between the two groups. The serum albumin, creatinine level, total lymphocyte count (TLC) and IgA in nutritional support group were significantly higher than those in control group (P <0.05) (P <0.05). The improvement rate of nutritional support group was 86.4% (19/22), and the average hospitalization time for treatment improvement was 15.8 ± 4.25 days. The improvement rate of treatment in control group (73.9%, 17/23). The mean length of hospital stay for treatment improvement was 20.6 ± 3.61 days, with significant difference between the two groups (P <0.05). The non-invasive ventilator off-line time in the nutrition support group was significantly shorter than that in the control group (P <0.05). Conclusion Reasonable nutrition therapy is of great importance in the treatment of acute pulmonary heart disease and respiratory failure.