摘要目的 探讨不同营养治疗方案对重度营养不良肺结核患者的临床疗效.方法 回顾性分析沈阳市胸科医院收治的82例肺结核合并重度营养不良患者的临床资料,按照不同的营养治疗方案,分为肠内营养组(EN组,40例)和肠外营养组(PN组,42例),比较两组治疗前后营养指标、免疫指标及健康评分SF-36的变化.结果 治疗后,EN组淋巴细胞总数、白蛋白、血红蛋白浓度、体质量指数均明显高于PN组(P<0.05);EN组CD3+显著高于PN组(P<0.05),EN组CD4+、CD8+、CD4+/CD8+均明显低于PN组(P<0.05);EN组总体健康、躯体功能、精神状态、疼痛与总分均显著低于PN组(P<0.05).结论 EN应用于重度营养不良合并肺结核患者可明显改善其营养指标、免疫指标,较为显著地提升患者的生存健康,对患者预后有良好的促进作用,是一种价格低廉,效果显著的可行方案.

abstractsObjective To investigate the clinical efficacy of different nutrition therapy for pulmo-nary tuberculosis patients with severe malnutrition. Methods A retrospective study was performed on 82 cases of pulmonary tuberculosis with severe malnutrition. According to the different methods,they were di-vided into the enteral nutrition group(EN group,n=40)and the parenteral nutrition group(PN group,n=42). The nutritional indexes before and after treatment,the changes of immune index and the health score SF-36 were compared. Results After the treatment, in EN group, TLC, HB and BMI were significantly higher than those in PN group(P<0. 05);in EN group,CD3+ was significantly higher than that in PN group (P<0. 05),CD4+,CD8+,CD4+ / CD8+ were significantly lower than those in PN group(P<0. 05);in EN group,the overall health,physical function,mental state,pain and total score were significantly lower than those in PN group(P<0. 05). Conclusion The application of EN for pulmonary tuberculosis patients with severe malnutrition can significantly improve the nutritional index,immune index and significantly improve patient survival state. It has a good effect on the prognosis of the patients,and it is an inexpensive and effec-tive feasible method.