[1]牛晓娜,魏 军,龚玉蕾,等.早期肠内营养对老年危重症机械通气病人短期预后的影响[J].肠外与肠内营养杂志,2020,(05):308-312320.[doi:10.16151/j.1007-810x.2020.04.012]
　NIU Xiao-na,WEI Jun,GONG Yu-lei,et al.The effect of early enteral nutrition on short-term clinical outcomes of elderly critical ill patients with mechanical ventilation[J].PARENTERAL & ENTERAL NUTRITION,2020,(05):308-312320.[doi:10.16151/j.1007-810x.2020.04.012]
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早期肠内营养对老年危重症机械通气病人短期预后的影响
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2020年05期
页码:
308-312320
栏目:
论著
出版日期:
2020-09-10

文章信息/Info

Title:
The effect of early enteral nutrition on short-term clinical outcomes of elderly critical ill patients with mechanical ventilation
作者:
牛晓娜; 魏 军; 龚玉蕾; 侯红云; 肖凤艳
首都医科大学宣武医院呼吸与危重症医学科，北京 100053
Author(s):
NIU Xiao-na;  WEI Jun;  GONG Yu-lei;  HOU Hong-yun;  XIAO Feng-yan
Department of Respiratory Intensive Care Unit, Xuan Wu Hospital, Capital Medical University,Beijing 100053, China
关键词:
早期肠内营养 ; 机械通气 ; 呼吸机相关性肺炎 ; 老年人 ; 预后
Keywords:
Early enteral nutrition;  Mechanical ventilation;  Ventilator associated pneumonia;  Elderly;  Prognosis
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2020.04.012
文献标志码:
A
摘要:
目的：研究早期肠内营养(EEN)对老年危重症机械通气病人短期预后的影响。 方法：选择 2016 年3月至 2018年 1 月首都医科大学宣武医院呼吸重症监护病房（RICU）收治的老年危重症机械通气病人86例，男54例，女32例，平均年龄(75.63 ± 4.41)岁。随机分为EEN组 41例和对照组[常规肠内营养(EN)]45例，分别于治疗前及治疗后7 d检测病人营养指标[血清白蛋白（ALB）、前白蛋白(PA)]和炎症指标[血清降钙素原（PCT）、超敏C-反应蛋白（hs-CRP）]，比较两组病人治疗后7 d营养状态、EN并发症情况、呼吸机相关性肺炎(VAP )发生率、机械通气时间以及RICU住院时间等指标变化，评价开展EEN对老年机械通气病人短期预后的影响。 结果：治疗7d后EEN组血清PA、ALB显著高于对照组(P < 0.05)，PCT、hs-CRP显著低于对照组(P < 0.05)。与对照组比，EEN组治疗后机械通气时间、RICU住院时间、院内感染发生率差异有统计学意义(P < 0.05)。EEN组病人发生呕吐、腹胀、腹泻、胃潴留等相关并发症发生率低于对照组(P < 0.05)。两组病人28 d死亡率差异无统计学意义（P > 0.05）。 结论：针对老年危重症机械通气病人开展EEN可以有效地降低VAP发生的风险，降低院内感染发生率，减少机械通气时间及住院时间。
Abstract:
Objective: To investigate the impact of early enteral nutrition on clinical outcomes in elderly critical ill patients requiring mechanical ventilation. Methods: A prospective randomized controlled trial was conducted. Eighty-six patients requiring mechanical ventilation admitted to respiratory intensive care unit (RICU) of Chaoyang Hospital from March 2016 to January 2018 were enrolled, and were randomly divided into early enteral nutrition (EEN) group (n = 41) and standard enteral nutrition (EN) group (n = 45). Both groups received nutrition therapy for seven days． The clinical data and laboratory examination results were collected and analyzed. Markers of nutritional status [pro albumin (PA), serum albumin (ALB)], inflammatory state [procalcitonin (PCT), hypersensitive C-reactive protein (hs CRP)] were detected on admission and 7 days after EN supplementation. The incidence of ventilator-associated pneumonia (VAP), enteral nutrition associated complications, duration of mechanical ventilation, length of RICU stay as well as 28-day mortality were also compared between the two groups． Results: Compared with baseline levels, the levels of serum PA and ALB were significantly increased after EN therapy in both groups, which were significantly higher in EEN group than in the standard EN group, and the levels of PCT and hs-CRP were significantly decreased, which were significantly lower in EEN group than that in the standard EN group (P < 0.05)． Compared with the standard EN group, duration of mechanical ventilation, length of RICU stay and RICU-associated infection were significantly decreased in EEN group (P < 0.05). In addition, the incidence of EN associated complications such as vomiting, abdominal distension, diarrhea and gastric retention were remarkably lower in EEN group compared with those in the control group (P < 0.05). There was no statistically significant difference in 28 days mortality between the two group (P > 0.05). Conclusion: EEN could effectively reduce the risk of developing VAP, shorten the duration of mechanical ventilation and hospital stay in elderly critical ill patients receiving mechanical ventilation.

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备注/Memo

备注/Memo:
作者简介 ：牛晓娜，主管护师，护理本科，从事呼吸与危重症医学专业。E-mail：niuxiaona163@163.com.cn 通讯作者 ：魏 军，E-mail：weijun010@126.corn
更新日期/Last Update: 1900-01-01