中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
1期
25-27
,共3页
颅内出血,高血压性%早期肠内营养%医院获得性肺炎%二重感染
顱內齣血,高血壓性%早期腸內營養%醫院穫得性肺炎%二重感染
로내출혈,고혈압성%조기장내영양%의원획득성폐염%이중감염
Intracranial hemorrhage hypertensive%Early enteral nutrition%Hospital acquired pneumonia%Superinfection
目的 探讨早期肠内营养(EN)对重症高血压性脑出血患者医院获得性肺炎(HAP)的临床价值.方法 将140例重症高血压性脑出血患者按随机数字表法分成治疗组和对照组,治疗组(70例)术后48 h开始EN支持.对照组(70例)术后第2天开始全胃肠外营养(TPN)支持.观察两组HAP发生率、HAP持续时间、肺部二重感染发生率、呼吸机使用率、呼吸机使用时间以及HAP病死率.结果 治疗组HAP发生率、肺部二重感染发生率、呼吸机使用率分别为30.0%(21/70)、12.9%(9/70)、35.7%(25/70),显著低于对照组的47.1%(33/70)、27.1%(19/70)、47.1%(33/70)(P＜0.05);治疗组HAP持续时间、呼吸机使用时间分别为(6.4±2.3)、(6.4±0.5)d,显著短于对照组的(15.6±2.1)、(11.4±0.3)d(P＜0.01或＜0.05).治疗组HAP病死率(8.6%,6/70)显著低于对照组(18.6%,13/70)(P＜0.05).结论 早期EN不仅能有效降低重症高血压性脑出血患者HAP和肺部二重感染的发生率,还可以降低呼吸机使用率,缩短呼吸机使用时间,最终缩短了HAP的治疗时间,降低了HAP的病死率.
目的 探討早期腸內營養(EN)對重癥高血壓性腦齣血患者醫院穫得性肺炎(HAP)的臨床價值.方法 將140例重癥高血壓性腦齣血患者按隨機數字錶法分成治療組和對照組,治療組(70例)術後48 h開始EN支持.對照組(70例)術後第2天開始全胃腸外營養(TPN)支持.觀察兩組HAP髮生率、HAP持續時間、肺部二重感染髮生率、呼吸機使用率、呼吸機使用時間以及HAP病死率.結果 治療組HAP髮生率、肺部二重感染髮生率、呼吸機使用率分彆為30.0%(21/70)、12.9%(9/70)、35.7%(25/70),顯著低于對照組的47.1%(33/70)、27.1%(19/70)、47.1%(33/70)(P＜0.05);治療組HAP持續時間、呼吸機使用時間分彆為(6.4±2.3)、(6.4±0.5)d,顯著短于對照組的(15.6±2.1)、(11.4±0.3)d(P＜0.01或＜0.05).治療組HAP病死率(8.6%,6/70)顯著低于對照組(18.6%,13/70)(P＜0.05).結論 早期EN不僅能有效降低重癥高血壓性腦齣血患者HAP和肺部二重感染的髮生率,還可以降低呼吸機使用率,縮短呼吸機使用時間,最終縮短瞭HAP的治療時間,降低瞭HAP的病死率.
목적 탐토조기장내영양(EN)대중증고혈압성뇌출혈환자의원획득성폐염(HAP)적림상개치.방법 장140례중증고혈압성뇌출혈환자안수궤수자표법분성치료조화대조조,치료조(70례)술후48 h개시EN지지.대조조(70례)술후제2천개시전위장외영양(TPN)지지.관찰량조HAP발생솔、HAP지속시간、폐부이중감염발생솔、호흡궤사용솔、호흡궤사용시간이급HAP병사솔.결과 치료조HAP발생솔、폐부이중감염발생솔、호흡궤사용솔분별위30.0%(21/70)、12.9%(9/70)、35.7%(25/70),현저저우대조조적47.1%(33/70)、27.1%(19/70)、47.1%(33/70)(P＜0.05);치료조HAP지속시간、호흡궤사용시간분별위(6.4±2.3)、(6.4±0.5)d,현저단우대조조적(15.6±2.1)、(11.4±0.3)d(P＜0.01혹＜0.05).치료조HAP병사솔(8.6%,6/70)현저저우대조조(18.6%,13/70)(P＜0.05).결론 조기EN불부능유효강저중증고혈압성뇌출혈환자HAP화폐부이중감염적발생솔,환가이강저호흡궤사용솔,축단호흡궤사용시간,최종축단료HAP적치료시간,강저료HAP적병사솔.
Objective To investigate the clinical value of early enteral nutrition (EN) on hospital acquired pneumonia (HAP) in postoperative patients with severe hypertensive cerebral hemorrhage.Methods One hundred and forty postoperative patients with severe hypertensive cerebral hemorrhage were divided into treatment group (70 cases) and controll group (70 cases) by random digits table. The treatment group was given EN from the second day after operation, while the control group was given total parenteral nutrition (TPN). The incidence and duration of HAP,the incidence of superinfection,the percent and duration of mechanical ventilation and the mortality rate of HAP was observed. Results The incidence of HAP, superinfection and using mechanical ventilation in treatment group [30.0% (21/70), 12.9% (9/70),35.7%(25/70)] were significantly lower than those in control group [47.1%(33/70) ,27.1%(19/70) ,47.1%( 33/70 )] (P ＜ 0.05 ). The duration of HAP and using mechanical ventilation in treatment group[(6.4 ± 2.3 ),(6.4 ± 0.5 ) d] were significantly lower than those in control group [( 15.6 ± 2.1 ), ( 11.4 ± 0.3 ) d] (P ＜ 0.01or ＜ 0.05 ). The mortality rate of HAP in treatment group was significantly lower than that in control group [8.6% (6/70) vs. 18.6% (13/70),P ＜0.05]. Conclusion Early EN not only effectively decreases the incidence of HAP and superinfection,but also decreases the incidence of mechanical ventilation, shortens the duration of mechanical ventilation and decreases the mortality rate of HAP.
