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目的:比较研究老年慢性阻塞性肺病急性发作(AECOPD)患者早期滋养性喂养与足量肠内喂养的优势。方法:将70例老年AECOPD患者随机入选早期滋养性喂养组(早期滋养组)与足量肠内喂养组(足量喂养组),每组35例,观察喂养期间并发症发生情况及临床结局。结果:早期滋养组腹胀发生率和中止喂养率均明显低于足量喂养组(2.86%vs.14.29%,P<0.01;2.86%vs.20.0%,P<0.01),机械通气(MV)时间和ICU停留时间均短于足量喂养组[(10.49±6.43)d vs.(12.36±8.54)d,P<0.01;(13.60±4.43)d vs.(16.25±5.36)d,P<0.05)];2组患者总住院时间和28d病死率比较差异无统计学意义(P>0.05)。结论:与足量肠内喂养策略比较,早期滋养性喂养治疗策略应用于老年AECOPD患者并发症更少,预后更好,建议结合临床情况合理使用。
OBJECTIVE: To compare the advantages of early nourishing and adequate enteral feeding in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Seventy elderly patients with AECOPD were enrolled in the early nourishment group (early nourish group) and full enteral feeding group (full-fat group), 35 cases in each group. The complication and clinical outcome during feeding were observed. Results: The rates of abdominal distension and discontinuation in early nourishment group were significantly lower than those in adequate feeding group (2.86% vs.14.29%, P <0.01; 2.86% vs.20.0%, P <0.01) And ICU were shorter than that of adequate feeding group [(10.49 ± 6.43) d vs. (12.36 ± 8.54) d, P <0.01; (13.60 ± 4.43) d vs. (16.25 ± 5.36) d, P <0.05) ]. There was no significant difference in the total hospital stay time and the 28-day mortality between the two groups (P> 0.05). Conclusion: Compared with adequate enteral feeding strategy, early nourishing feeding strategy applied to elderly patients with AECOPD has fewer complications and better prognosis. It is suggested that rational use should be made in combination with clinical conditions.