早期肠内营养支持对超高龄老年肺部感染患者的疗效观察
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摘要
目的:探讨早期肠内营养支持对超高龄老年肺部感染患者的疗效。方法:选择70例超高龄老年肺部感染患者,按是否愿意接受肠内营养分为研究组(n=34)和对照组(n=36)。两组患者均给予常规治疗,研究组另外接受早期肠内营养支持,对照组则进行自由饮食。比较治疗前后两组的营养指标、治愈情况和不良反应发生情况。结果:治疗后,研究组的身体质量指数(body mass index,BMI)、血红蛋白、血清总蛋白、血清白蛋白、前白蛋白水平均较对照组有明显上升,logNT-proBNP较对照组明显下降,差异均有统计学意义(P<0.05);治疗后,两组的上臂中部周径(mid-arm circumference,MAC)、肱三头肌皮褶厚度(triceps skim fold,TSF)和治愈率比较,差异均无统计学意义(P>0.05);研究组的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:早期肠内营养支持可以改善超高龄老年肺部感染患者的营养状况及预后,值得推广。
Objective:To investigate the curative effect of early enteral nutrition support on the elderly patients with pulmonary infection.Method:70 elderly patients with pulmonary infection were divided into study group(n=34)and control group(n=36)according to their willingness to receive enteral nutrition.Two groups of patients were given routine treatment,the study group received additional early enteral nutrition support,the control group was on a free diet.The curative effect and adverse reaction of the two groups were compared before and after treatment.Result:After treatment,the body mass index(BMI),hemoglobin,serum total protein,serum albumin,prealbumin levels in the study group were significantly increased compared with those in control group,and lognt-probnp was significantly decreased compared with that in control group,with statistically significant differences(P<0.05).After treatment,there were no statistically significant differences in mid-arm circumference(MAC),triceps skim fold(TSF)and cure rate between the two groups(P>0.05).The incidence of adverse reactions in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Early enteral nutrition support can improve the nutritional status and prognosis of the elderly patients with pulmonary infection,it is worthy of promotion.
Objective:To investigate the curative effect of early enteral nutrition support on the elderly patients with pulmonary infection.Method:70 elderly patients with pulmonary infection were divided into study group(n=34)and control group(n=36)according to their willingness to receive enteral nutrition.Two groups of patients were given routine treatment,the study group received additional early enteral nutrition support,the control group was on a free diet.The curative effect and adverse reaction of the two groups were compared before and after treatment.Result:After treatment,the body mass index(BMI),hemoglobin,serum total protein,serum albumin,prealbumin levels in the study group were significantly increased compared with those in control group,and lognt-probnp was significantly decreased compared with that in control group,with statistically significant differences(P<0.05).After treatment,there were no statistically significant differences in mid-arm circumference(MAC),triceps skim fold(TSF)and cure rate between the two groups(P>0.05).The incidence of adverse reactions in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Early enteral nutrition support can improve the nutritional status and prognosis of the elderly patients with pulmonary infection,it is worthy of promotion.
引文
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[16]陈贤勇,张智.肠内营养支持对老年慢性阻塞性肺疾病患者机体免疫力和营养指数及预后的影响[J].医学综述,2015,21(9):1715-1717.
[17]吕卓江,吴庭安,张道进,等.肠内营养支持对老年AECOPD并呼吸衰竭患者的心肺功能及营养免疫状况中的影响[J].中国当代医药,2017,24(20):26-29.
[18]彭顺刚,卢建刚,曾秋蓉,等.肠内营养支持对老年慢阻肺急性加重期合并呼吸衰竭患者心肺功能及免疫功能的影响[J].临床肺科杂志,2016,21(2):261-264.
[19]吕心阳.百普力用于老年危重症患者肠内营养疗效观察[J].国际老年医学杂志,2016,37(6):279-281.
[20]熊晓炜,郑永科.早期营养治疗在老年重症患者的应用价值[J].全科医学临床与教育,2017,15(2):182-184.
[2]楼晓霞,徐尚志,沈丽丽.肠内营养联合莫沙必利在老年医院获得性肺炎病人中应用的疗效观察[J].肠外与肠内营养,2013,20(5):282-284.
[3]李音,姜红妮,瞿介明.老年、高龄老年和超高龄老年社区获得性肺炎的临床特征及预后对照分析[J].老年医学与保健,2016,22(1):19-23.
[4]史秋香,吴艳峰.营养支持治疗在老年呼吸系统疾病中的价值[J].中国老年学杂志,2017,37(9):2229-2230.
[5]仰柯,魏彩虹,张文广,等.家庭无创通气对COPD并呼吸衰竭患者营养状况及免疫功能的影响[J].中国临床研究,2014,27(6):664-666.
[6]杨雪.肠内营养支持对重症患者治疗临床效果观察[J].当代医学,2013,19(13):114-115.
[7]齐玲,孙惠杰,赵英凯,等.老年重症肺炎的肠内外营养支持疗法的效果[J].中外医学研究,2013,11(26):116.
[8]Calleja Fernandez A,Vidal Casariego A,Ballesteros Pomar MD.Comparative stud y of total energy expenditure estimated by sense wear armband and harris-benedict equation in healthy ambulatory population;utility in clinical practice[J].Nutr Hosp,2012,27(4):1244-1247.
[9]包勤文,龚晨,申潇竹,等.肠内营养支持对社区获得性肺炎高龄患者预后的影响[J].医药导报,2017,36(3):292-295.
[10]吴宁,齐玉琴,陈雪松,等.呼吸支持联合营养支持在高龄重症肺炎患者中的临床应用[J].中华老年多器官疾病杂志,2013,12(1):29-33.
[11]曹义,高莉,高翔,等.老年重症肺炎患者肠内外营养治疗的疗效观察[J].中国现代药物应用,2016,10(1):75-76.
[12]Tu G W,Ju M J,Han Y,et al.Moderate-dose glucocorticoids as salvage therapy for severe pneumonia in renal transplant recipients:a single-center feasibility study[J].Renal Failure,2014,36(2):202-209.
[13]卢薇,郑永科,顾南嫒,等.两种肠内营养液应用于老年重症肺炎患者血糖控制的临床疗效对比[J].全科医学临床与教育,2016,14(2):152-154.
[14]李雷,史佳.临床肠内营养支持对老年慢性阻塞性肺病患者心肺功能影响的干预研究[J].中华老年心脑血管病杂志,2014,16(6):599-601.
[15]张莹,慕广建,施伟,等.老年心力衰竭合并慢性阻塞性肺病急性加重患者营养状态与免疫功能相关性分析[J].中华老年心脑血管病杂志,2013,15(7):704-706.
[16]陈贤勇,张智.肠内营养支持对老年慢性阻塞性肺疾病患者机体免疫力和营养指数及预后的影响[J].医学综述,2015,21(9):1715-1717.
[17]吕卓江,吴庭安,张道进,等.肠内营养支持对老年AECOPD并呼吸衰竭患者的心肺功能及营养免疫状况中的影响[J].中国当代医药,2017,24(20):26-29.
[18]彭顺刚,卢建刚,曾秋蓉,等.肠内营养支持对老年慢阻肺急性加重期合并呼吸衰竭患者心肺功能及免疫功能的影响[J].临床肺科杂志,2016,21(2):261-264.
[19]吕心阳.百普力用于老年危重症患者肠内营养疗效观察[J].国际老年医学杂志,2016,37(6):279-281.
[20]熊晓炜,郑永科.早期营养治疗在老年重症患者的应用价值[J].全科医学临床与教育,2017,15(2):182-184.