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目的观察营养支持及不同途径在无创通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者中的作用。方法选取呼吸内科住院的COPD合并呼吸衰竭而行无创通气的患者60例,随机分为肠内营养组、静脉营养组与对照组,分别给予能全力、3 L袋与普通流质,对比营养指标变化、血气、机械通气时间、插管率与病死率。结果肠内营养组的营养指标(白蛋白、前白蛋白、免疫球蛋白等)较治疗前明显好转(P<0.05),肠内营养组与静脉营养组PO2均明显升高,PCO2明显下降,与治疗前比较,差异有统计学意义(P<0.05),在机械通气时间、插管率与病死率,肠内营养组、静脉营养组与对照组比较差异有统计学意义(P<0.05)。结论COPD合并呼吸衰竭的患者,在行无创通气的同时,给予营养支持治疗是非常必要的,对于有完整胃肠道功能的患者应首选肠内营养,将有助于改善机体的营养状况,改善免疫功能,从而提高治疗的综合效果。
Objective To observe the role of nutritional support and different approaches in the treatment of patients with chronic obstructive pulmonary disease (COPD) and respiratory failure by non-invasive ventilation. Methods Sixty patients with noninvasive ventilation who were hospitalized with COPD and respiratory failure were enrolled in this study. They were randomly divided into enteral nutrition group, intravenous nutrition group and control group, and were given full, 3 L bags and normal fluid respectively. , Blood gas, mechanical ventilation time, intubation rate and fatality rate. Results The nutritional indexes (albumin, prealbumin, immunoglobulin, etc.) in enteral nutrition group were significantly improved (P <0.05), the PO2 values in enteral nutrition group and intravenous nutrition group were significantly increased, PCO2 was significantly decreased, Compared with those before treatment, the difference was statistically significant (P <0.05). There were significant differences in mechanical ventilation time, intubation rate and mortality, enteral nutrition group and intravenous nutrition group compared with the control group (P <0.05) . Conclusions Patients with COPD complicated with respiratory failure should be given essential nutritional support while performing non-invasive ventilation. Enteral nutrition should be the first choice for patients with complete gastrointestinal function, which will help to improve the nutritional status of the body and improve Immune function, thereby enhancing the comprehensive effect of treatment.