早期营养支持降低ICU肿瘤重症患者呼吸机相关性肺炎的临床效果被引量：26

Clinical study of early nutritional support for cancer patients with severe lower ICU ventilator- associated pneumonia

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摘要目的:探讨早期营养支持对降低ICU肿瘤重症患者呼吸机相关性肺炎的临床效果,改善ICU肿瘤重症患者预后。方法:选取ICU病房收治的行气管插管机械通气治疗的肿瘤重症患者140例,随机分为两组,使其有可比性。对照组患者给予常规营养支持;观察组患者给予早期肠内+肠外营养支持。对两组患者呼吸机肺炎(VAP)发生率、机械通气时间、住院时间以及21d病死率进行统计;分别于入ICU第1d和治疗14d后测定两组患者血红蛋白、淋巴细胞计数、血清总蛋白以及血清白蛋白水平。结果:观察组患者VAP发生率、机械通气时间、住院时间以及21d死亡率分别为13.70%、(8.52±3.28)d、(11.14±1.38)d和9.59%,均明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗前两组患者血红蛋白、淋巴细胞计数、白蛋白以及总蛋白水平差别不大,无统计学意义(P>0.05)。经过治疗,观察组患者上述指标分别为(108.36±8.21)g/L、(16.92±1.35)×109/L、(34.45±2.81)g/L和(60.08±3.79)g/L,均明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论:早期营养支持可以有效降低ICU肿瘤重症患者呼吸机相关性肺炎的发生几率,改善患者的营养状况和预后。 Objective： To investigate the clinical results of early nutritional support for cancer patients with severe lower ICU ventilator- associated pneumonia to improve the prognosis of patients with severe cancer ICU. Methods：Tumor patients admitted in ICU with severe tracheal intubation with mechanical ventilation in the treatment of 140 cases were randomly divided into two groups. The control group patients were treated with conventional nutritional support,observation group were given enteral ＋ parenteral nutritional support. Two groups of patients were observed for ventilator pneumonia（ VAP） incidence,duration of mechanical ventilation,length of stay and mortality statistics 21 d.Results： The incidence of patients with VAP,duration of mechanical ventilation,length of stay and 21 d mortality rates were 13. 70%,（ 8. 52 ± 3. 28） d,（ 11. 14 ± 1. 38） d and 9. 59%,significantly lower than the control group the difference was statistically significant（ P〈0. 05）. Two groups of patients before treatment,hemoglobin,lymphocyte count,albumin,and total protein levels difference was not statistically significant（ P〈0. 05）. After treatment,patients in the observation group above indicators were（ 108. 36 ± 8. 21） g / L,（ 16. 92 ± 1. 35） × 10^9/ L,（ 34. 45 ± 2. 81） g / L and（ 60. 08 ± 3. 79） g/L,were significantly higher in the control group,the difference was statistically significant（ P〈0. 05）. Conclusion： Early nutritional support can effectively reduce the incidence of cancer in patients with severe ICU ventilator- associated pneumonia chance to improve the nutritional status of patients and prognosis.

作者王颖刘世炎

机构地区唐山市人民医院

出处《现代肿瘤医学》 CAS 2016年第2期282-284,共3页 Journal of Modern Oncology

基金唐山市科技局项目(编号:12130209b)

关键词营养支持 ICU 肿瘤呼吸机相关性肺炎 nutritional support ICU tumor ventilator-associated pneumonia

分类号 R730.6 [医药卫生—肿瘤]

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1Alhazzani W, Almasoud A, Jaesehke R, et al. Small bowel feeding and risk of pneumonia in adult critically ill patients: A systematic review and meta -analysis of randomized trials [ J ]. Critical Care, 2013,17(4) :R127.
2Piazza 0, Wang X. A translational approach to ventilator associatedpneumonia [ J ]. Clin Translational Med, 2014,3 : 26.
3Wang J, Liu K, Ariani F, et al. Probiotics for preventing wntilatm - associated pneumonia: A systematic review and Meta analysis of high- quality randomized controlled trials [ J ]. Salloh PLoS One, 2013,8(12) : e83934.
4Coppadoro A, Bittner E, Berra L. Novel preventive strategies for ventilator - associated pneumonia [ J ]. Critical Care, 2012,16 ( 2 ) : 210.
5Aydogmu MT,Tomak Y, Tekin M, et al. Glutamine supplemented parenteral nutrition to prevent ventilator- associated pneumonia ir the intensive care unit [ J ]. Balkan Med J, 2012,29 ( 4 ) : 414 418.
6Chung CK, Whitney R, Thompson CM, et al. Experience with an enteral- based nutritional support regimen in eritically illtramnu patients [ J ]J Am College of Surgeons,2013,217 ( 6 ) : 10.