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目的:分析老年重症ICU患者选择不同营养支持途径的效果及预后。方法:选取2012年1月到2014年12月来宁波市北仑区人民医院就诊的老年重症ICU患者80例,按照患者具体病情,将此80例患者平均分为观察组和对照组。对照组患者接受肠内营养支持治疗。观察组患者给予肠内肠外联合营养支持疗法,即热卡不足部分联合静脉营养支持治疗补足,比较两组患者营养支持前后指标变化、机械通气时间、住院时间、住院费用、并发症发生情况。结果:观察组和对照组治疗前淋巴细胞数、血清白蛋白、体重差异无统计学意义(P>0.05)。观察组治疗后,淋巴细胞数、血清白蛋白与治疗前相比变化明显(P<0.05)。对照组患者治疗后淋巴细胞数、血清白蛋白、体重均较治疗前上升(P<0.05)。治疗后两组患者各项指标差异不显著(P>0.05)。两组患者机械通气时间、住院时间差异无统计学意义(P>0.05),在住院费用方面,观察组患者花费较高,两组患者差异显著(P<0.05)。观察组患者的并发症发生情况和病死率较高,对照组患者身体状况明显优于对照组。两组患者治疗后并发症发生率差异显著(P<0.05)。结论:联合营养支持疗法在老年重症ICU患者的治疗中易发生感染,并发症发生率较单纯肠内营养支持治疗高,治疗时花费较高。
Objective: To analyze the effect and prognosis of elderly patients with severe ICU in choosing different nutritional support ways. Methods: A total of 80 elderly patients with severe ICU from January 2012 to December 2014 in Beilun District People’s Hospital of Ningbo City were enrolled. According to their specific condition, the 80 patients were equally divided into observation group and control group. Patients in the control group received enteral nutrition support. The patients in the observation group were given parenteral nutrition support therapy, namely, the insufficiency of caloric insufficiency combined with intravenous nutrition support therapy. The changes of indexes before and after nutritional support, mechanical ventilation time, hospitalization time, hospitalization expenses and complications were compared between the two groups. Results: There was no significant difference in lymphocyte count, serum albumin and body weight between observation group and control group before treatment (P> 0.05). After treatment, the number of lymphocytes and serum albumin in observation group changed significantly compared with those before treatment (P <0.05). After treatment, the number of lymphocytes, serum albumin and body weight in control group increased compared with those before treatment (P <0.05). After treatment, there was no significant difference between the two groups (P> 0.05). There was no significant difference in mechanical ventilation time and hospital stay between the two groups (P> 0.05). In the aspect of hospitalization cost, the patients in the observation group spent more, and the difference between the two groups was significant (P <0.05). Observation group patients with complications and higher mortality, the control group patients physical condition was significantly better than the control group. The difference in the incidence of complications between the two groups was significant (P <0.05). CONCLUSION: Combined nutrition support therapy is prone to infection in the treatment of elderly patients with severe ICU. The complication rate is higher than that of simple enteral nutrition support and is expensive to treat.