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营养支持对急性发作期COPD患者的效果观察 ?(1)
http://www.100md.com 2020年4月15日 《中外医学研究》 202011
     【摘要】 目的:探析营养支持对急性发作期慢性阻塞性肺疾病(COPD)患者的效果。方法:将笔者所在医院呼吸内科2019年4-10月收治的100例急性发作期COPD患者纳入观察中,基于随机数字表法分成研究组和对照组,每组50例;两组均给予专科对症治疗,对照组给予常规膳食,研究组同时行肠内营养(EN),对比两组临床疗效,并测定干预前后患者营养状况。结果:研究组机械通气时间、症状缓解时间均早于对照组,差异有统计学意义(P<0.05)。干预后,两组ALB、PALB均有改善,但研究组均显著高于对照组(P<0.05)。研究组临床总有效率为96.00%,高于对照组的88.00%,差异有统计学意义(P<0.05)。结论:在急性发作期COPD治疗中配合营养支持,可有效促进病情转归,改善患者机体营养状态,提升临床效果,有着重要临床价值。

    【关键词】 慢性阻塞性肺疾病 急性发作期 营养支持 免疫功能

    [Abstract] Objective: To explore the effect of nutritional support on patients with COPD in acute attack stage. Method: A total of 100 patients with COPD in acute attack stage who admitted to respiratory department of our hospital from April to October 2019 were included in the observation. Based on the method of random number table, they were divided into the study group and the control group, 50 cases in each group. The two groups were given special symptomatic treatment, the control group was given conventional diet, the study group was given enteral nutrition (EN) at the same time. The clinical efficacy of the two groups was compared, and the nutritional status of patients before and after the intervention were determined. Result: The mechanical ventilation time and symptom relief time in the study group were earlier than those in the control group, the differences were statistically significant (P<0.05). After intervention, ALB and PALB of the two groups were improved, but those of the study group were significantly higher than those of the control group (P<0.05). The total clinical effective rate of the study group was 96.00%, which was higher than 88.00% of the control group (P<0.05). Conclusion: In the treatment of COPD in acute attack stage, nutritional support can effectively promote the outcome of the disease, improve the nutritional status of patients, and improve the clinical effect, which has important clinical value.

    COPD是临床呼吸内科常见的一种慢性病症,以持续性气流受阻为病理特征,有着较高发病率,以中老年人为主要发病群体[1]。临床表现为咳嗽、咳痰、胸闷等,在急性期会显著加重,且反复发作,严重影响到患者身心健康,增加家庭经济负担。营养缺乏是COPD患者常见的并发表现,据报道,在COPD的发展中通常伴不同程度的营养不良,并发率在24%~71%[2]。COPD患者因长期缺氧、CO2潴留,同时机体处于高分解代谢状态,能量消耗会明显增加,再加上长期摄入不足,会导致呼吸肌功能下降与机体免疫功能受损,在疾病急性加重期更为严重,对临床疗效和预后造成极大影响。基于此,在COPD急性加重期治疗期间如何给予患者营养支持成为临床研究热点。本文对笔者所在医院收治的100例急性发作期COPD患者的临床干预进行研究,分析营养支持的临床效果,现报告如下。

    1 资料与方法

    1.1 一般资料

    将2019年4-10月在笔者所在医院呼吸内科住院治疗的100例急性发作期COPD患者作为观察对象,均经症状、影像学、实验室培养等检查确诊,符合文献[3]《慢性阻塞性肺疾病诊疗指南》相关诊断标准。临床表现咳嗽、咳痰、喘息、痰多而稠。纳入标准:(1)确诊为COPD,且处于急性发作期;(2)入院前未应用过免疫调节剂;(3)患者意识清楚,能正常语言交流。排除标准:(1)肝肾功能不全;(2)肺心病、脑血管疾病、胸腔积液及其他呼吸系统病症;(3)不能配合临床干预。通过随机数字表法分成两组,均为50例。其中,对照组:男女分别为31、19例;年龄45~68岁,平均(53.6±3.2)岁;急性期病程3~12 d,平均(5.7±1.4)d。研究组:男女分别28、22例;年龄48~66岁,平均(54.1±2.9)岁;急性期病程3~14 d,平均(5.5±1.5)d。两组性别、年龄、急性期病程等差异无统计学意义(P>0.05),具有良好可比性。患者對本研究知情同意。本研究通过医院伦理委员会审核。, 百拇医药(李雪婷)
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