重症监护室老年重症患者应用营养支持优化疗法的临床观察

Clinical observation of optimized nutrition support therapy in elderly patients with severe diseases in intensive care unit

中文关键词: 老年  重症  重症监护室  营养支持  淋巴细胞计数  血清白蛋白  人体质量指数

英文关键词: elderly  severe disease  intensive care unit  nutritional support  lymphocyte count  serum albumin  body mass index

中文摘要:

      目的 探讨营养支持优化疗法对老年重症监护室(ICU)重症患者淋巴细胞计数、血清白蛋白和人体质量指数(BMI)等的影响.方法 选取2022 年1 月—2022 年12 月于海安市人民医院ICU诊治的老年重症患者82 例,根据数字表法随机分为:观察组(n =41)和对照组(n =41).对照组采取常规肠内营养支持疗法,观察组采取肠内营养支持优化疗法.观察并比较2 组淋巴细胞计数、血清白蛋白、BMI、心功能和炎性因子变化;使用急性生理学及慢性健康状况(APACHE Ⅱ)评分系统评估并比较2 组治疗前、治疗7d时病情情况;比较 2 组机械通气时间、入住ICU时间和住院时间、并发症发生情况.结果 治疗7d,2 组淋巴细胞计数均高于同组治疗前(P＜0.05),左室收缩末期内径(LVESD)、APACHE Ⅱ评分和血清 C 反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于同组治疗前(P＜0.05);观察组血清白蛋白水平高于治疗前(P＜0.05);观察组淋巴细胞计数、血清白蛋白水平和BMI均高于对照组(P＜0.05);观察组APACHE Ⅱ评分和血清CRP、IL-6、TNF-α水平低于对照组(P＜0.05);观察组机械通气时间、入住ICU时间和住院时间均短于对照组(P＜0.05);观察组总并发症发生率低于对照组(P＜0.05).结论 给予老年ICU重症患者营养支持优化疗法有利于患者免疫力提高,改善机体炎症反应,促进患者康复,降低并发症发生率,缩短住院治疗时间.

英文摘要:

      Objective To explore the effects of optimized nutrition support therapy on lymphocyte count, serum albu? min, and body mass index (BMI) in elderly patients with severe diseases in intensive care unit (ICU). Methods A total of 82 elderly critically ill patients who were diagnosed and treated in ICU of People??s Hospital of Hai??an City from January 2022 to December 2022 were selected and randomly divided into observation group (n =41) and control group (n =41) according to the number table method. The control group received routine enteral nutrition support therapy, while the observation group re? ceived optimized enteral nutrition support therapy. The changes of lymphocyte count, serum albumin, BMI, heart function and inflammatory factors were observed and compared between the two groups. The Acute Physiology and Chronic Health evalua? tion II (APACHE II) scoring system was used to evaluate and compare the conditions of patients in the two groups before and after 7 days of treatment. The mechanical ventilation time, ICU stay time, hospitalization time and complications were com? pared between the two groups. Results After 7 days of treatment, the lymphocyte count of both groups was higher than that of the same group before treatment (P < 0. 05), while the left ventricular end?systolic diameter (LVESD), APACHE II score and the levels of serum C?reactive protein (CRP), interleukin?6 (IL?6) and tumor necrosis factor?α (TNF?α) were lower than those of the same group before treatment (P <0. 05). The serum albumin level of the observation group after 7 days of treat? ment was higher than before treatment (P < 0. 05); the lymphocyte count, serum albumin level and BMI of the observation group were higher than those of the control group after 7 days of treatment (P <0. 05), APACHE II score and the levels of se? rum CRP, IL?6 and TNF?α of the observation group were lower than those of the control group (P < 0. 05); the mechanical ventilation time, ICU stay time and hospitalization time of the observation group were shorter than those of the control group (P <0. 05). The total incidence of complications in the observation group was lower than that in the control group (P < 0?? 05). Conclusion For elderly ICU patients with severe illness, the optimized nutrition support therapy is beneficial to en? hance the immunity of patients, relieve the inflammatory response of the body, promote disease recovery, reduce the incidence of complications, and shorten the hospitalization time.