早期肠内营养与肠外营养治疗重症监护病房机械通气患者的临床效果比较

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Abstract Objective To explore the clinical effect of early enteral nutrition （EN) and parenteral nutrition (PN) in patients with mechanical ventilation in intensive care unit (ICU). Methods A retrospective analysis of 86 mechanically ventilated patients admitted to the ICU from January 2015 to October 2019 was made. Within 48 hours after admission，the patients who received enteral nutrition were performed in EN group (56 cases)，those who received parenteral nutrition (30 cases) were performed in PN group，at the same time they were given conventional treatment. After entering the ICU and after 7 days of treatment，the triceps skin fold thickness (TSF) and upper arm muscle circumference (AMC)，hemoglobin (Hb)，blood C-reactive protein (CRP)，albumin (ALB)，gluten alanine aminotransferase (ALT) levels were compared. The time of mechanical ventilation，ICU hospital stay，the presence or absence of ventilator-associated pneumonia (VAP) and gastrointestinal bleeding were compared between the two groups. Results After 7 days of nutritional support treatment in the EN group，Hb was slightly higher than that before treatment，the difference was not statistically significant (P＞0.05)； ALB was higher than that before treatment，the difference was statistically significant (P＜0.05).After nutritional support in the PN group，Hb was lower than that before treatment，the difference was statistically significant (P＜0.05)； while ALB compared with nutritional treatment，the difference was not statistically significant (P＞0.05)； after treatment between the two groups，only Hb and ALB in EN group were higher than those in PN group，the difference was statistically significant (P＜0.05). The mechanical ventilation time and ICU hospital stay in the PN group were longer than those in the EN group，and the difference was statistically significant (P＜0.05)； the 2-week success rate of withdrawal in the EN group was higher than that in the PN group，and the difference was statistically significant (P＜0.05). In the EN group ，the incidence of VAP，the incidence of gastrointestinal hemorrhage，and the 28-day mortality were lower than those of the PN group，but the difference was not statistically significant (P＞0.05). Conclusion The early metabolic effect of EN in patients with mechanical ventilation is better and more in line with the physiological state，which can improve the success rate of withdrawal，shorten the time of mechanical ventilation，reduce complications，and thus improve the prognosis and shorten the hospital stay.

Key words： Mechanical ventilation Early Enteral nutrition Parenteral nutrition

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	ZHAN Zhi-Fang
	CUI XI-jun

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ZHAN Zhi-Fang,CUI XI-jun. Clinical effect comparison of early enteral nutrition and parenteral nutrition in the treatment of patients with mechanical ventilation in the intensive care unit[J]. 中国当代医药, 2020, 27(18): 46-49.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I18/46

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