CAJ | 학술논문

目的：探讨早期肠内营养对营养不良老年心衰患者心功能及预后的影响。方法选择80例心力衰竭合并营养不良的老年患者，按照随机数字法分为观察组与对照组，每组40例。观察组进行早期的肠内营养支持，对照组进行常规饮食，比较两组治疗前后前白蛋白，转铁蛋白变化情况，及治疗后两组左室射血分数、体内炎症细胞因子变化及发生的并发症。结果观察组治疗后前白蛋白、转铁蛋白均高于治疗前及治疗后对照组(P<0．05)，治疗后观察组B型脑钠肽显著低于对照组(P<0．05)，左室射血分数高于对照组(P<0．05)。治疗过程中，观察组发生低钠血症、高钠血症、高血糖以及二重感染比例低于对照组(P<0．05)。结论对心衰合并营养不良的老年患者实施早期的肠内营养支持，在保证机体能量补充的同时，更好的维持电解质平衡，改善患者营养状况从而改善免疫功能，起到了综合治疗的目的。
목적：탐토조기장내영양대영양불량노년심쇠환자심공능급예후적영향。방법선택80례심력쇠갈합병영양불량적노년환자，안조수궤수자법분위관찰조여대조조，매조40례。관찰조진행조기적장내영양지지，대조조진행상규음식，비교량조치료전후전백단백，전철단백변화정황，급치료후량조좌실사혈분수、체내염증세포인자변화급발생적병발증。결과관찰조치료후전백단백、전철단백균고우치료전급치료후대조조(P<0．05)，치료후관찰조B형뇌납태현저저우대조조(P<0．05)，좌실사혈분수고우대조조(P<0．05)。치료과정중，관찰조발생저납혈증、고납혈증、고혈당이급이중감염비례저우대조조(P<0．05)。결론대심쇠합병영양불량적노년환자실시조기적장내영양지지，재보증궤체능량보충적동시，경호적유지전해질평형，개선환자영양상황종이개선면역공능，기도료종합치료적목적。
Objective To investigate the effect of early enteral nutrition on malnutrition for heart failure with heart function and prog-nosis in the elderly. Methods Eighty cases of heart failure together with malnutrition were chosen and randomized into the observation group and the control group, with 40 in each. The observation group used early enteral nutrition support, while the control group were treated with conventional diet, then albumin, transferrin changes before and after treatment were compared, and left ventricular ejection fraction complica-tions, changes in body cells and inflammatory cytokines occurs and sodium levels after treatment were compared. Results In the observation group after treatment with prealbumin, transferrin was higher than that before and after treatment of control group(P<0. 05);after treatment, BNP, CRP of the observation group were lower than those of control ( P<0. 05 ); left ventricular ejection fraction in the observation group was higher than that in the control (P<0. 05);hyponatremia, hypernatremia, hyperglycemia and superinfection ratio were lower than control group(P<0. 05). Conclusion To implement the early enteral nutrition support in malnourished elderly patients with heart failure can en-sure complement the body′s energy and better maintain electrolyte balance, and reduce the body′s inflammatory response, so it can improve the nutritional status and thus improve immune function, thus achieving the purpose of comprehensive treatment.