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目的:观察慢性阻塞性肺病(COPD)并发呼吸衰竭病人EEN支持的疗效。方法:63例COPD并发呼吸衰竭病人在开始机械通气时,随机分为EEN组32例和延迟EN(DEN)组31例,比较两组病人营养支持2周后的各项生化指标、机械通气时间、并发症和病死率等。结果:治疗2周后,EEN组病人血清总蛋白、ALB、PA和Hb水平无明显下降(P>0.05),但DEN组上述指标较治疗前明显下降,差异有显著性意义(P<0.05)。EEN组与DEN组相比,机械通气时间明显缩短,腹胀、腹泻、消化道出血、二重感染、肝功能损害、高血糖等发生率明显降低,病死率亦有所降低,差异有显著性意义(P<0.05)。结论:COPD并发呼吸衰竭病人行EEN支持治疗,能改善病人的营养状况,减少并发症,缩短机械通气时间和降低最终病死率,是较好的营养支持方式。
Objective: To observe the efficacy of EEN in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods: Sixty-three COPD patients with respiratory failure were randomly divided into EEN group (n = 32) and delayed enteral nutrition group (n = 31). The biochemical indexes of two groups were compared after two weeks of nutritional support. The duration of mechanical ventilation , Complications and mortality and so on. Results: After 2 weeks of treatment, the levels of serum total protein, ALB, PA and Hb in EEN group were not significantly decreased (P> 0.05), but the above parameters in DEN group were significantly lower than those before treatment (P <0.05) . EEN group compared with DEN group, mechanical ventilation time was significantly shortened, abdominal distension, diarrhea, gastrointestinal bleeding, double infection, liver damage, high blood sugar and other significantly reduced the incidence, mortality also decreased, the difference was statistically significant (P <0.05). CONCLUSIONS: EEN supportive treatment of COPD patients with respiratory failure can improve nutritional status of patients, reduce complications, shorten the duration of mechanical ventilation and reduce the final mortality rate, which is a good nutritional support.