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摘要: 目的:探讨早期开通肠内营养对中重度心功能不全患者临床预后的影响。方法:连续选取2017年1月-2020年1月就诊于首都医科大学宣武医院急诊科的心功能Ⅲ/Ⅳ级(纽约心脏病协会的心功能分级标准)的慢性心功能不全患者157例,根据是否早期开通肠内营养,将受试者分为试验组:早期予以肠内营养(入院早期即予以肠内营养至出院前一天);对照组:未予以肠内营养,检测两组受试者NT-proBNP、心脏超声、D乳酸、降结肠至乙状结肠的平均肠壁厚度,并记录两组患者入院平均住院时间、住院费用等临床资料。结果:试验组和对照组出院前NT-proBNP分别为(792.15±102.75)pg/mL、(1082.26±246.78)pg/mL,血液D乳酸浓度分别为(953.42±72.20)pg/mL、(2653.23±66.72)pg/mL,降结肠至乙状结肠的平均厚度分别为(2.62±0.23)mm、(3.69±0.16)mm,差异均有统计学意义(均P<0.05);另外,试验组和对照组的平均住院天数分别为(6.06±0.13)d、(9.12±0.65)d,住院费用分别为(10 596.23±106.45)元、(15 639.72±189.80)元,差异均有统计学意义(均P<0.05)。结论:早期开通中重度心功能不全患者的肠内营养有利于减轻该类患者的肠黏膜损伤,对于减少该类患者的平均住院时间、住院费用以及临床不良事件具有重要的作用。Abstract: Objective:To investigate the effect of early enteral nutrition on the prognosis of patients with New York Heart Association(NYHA) classⅢ/Ⅳ.Methods:One hundred and fifty-seven patients with NYHA class Ⅲ/Ⅳ, who were enrolled from the emergency department of Xuanwu Hospital of Capital Medical University from 2017 January to 2020 January. According to whether early enteral nutrition administration, patients were randomly divided into 2 groups. Treatment group:early enteral nutrition administration was supported as soon as patients enrolled; Control group:no enteral nutrition administration was supplied. NT-proBNP, echocardiography, D-lactate, average colon wall thickness(aCWT) from the ascending colon to sigmoid colon and average hospital of stay and average hospital charges for the patients were recorded.Results:The level of NT-proBNP and D-lactate and aCWT in treatment group were significantly lower than those in control group[(792.15±102.75) pg/mL vs.(1082.26±246.78) pg/mL,(953.42±72.20) pg/mL vs.(2653.23±66.72) pg/mL,(2.62±0.23)mm vs.(3.69±0.16)mm, all P<0.05]; In addition, average hospital stay and average hospital charges for the patients in treatment group were significantly less than thoes in control group[(6.06±0.13) d vs.(9.12±0.65) d,(10 596.23±106.45) yuan vs.(15 639.72±189.80) yuan, all P<0.05].Conclusion:Early enteral nutrition is beneficial for HF patients with NYHA class Ⅲ/Ⅳ.
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