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Objective To observe the curative effect of nourishing the lung and strengthening the spleen and nourishing the lung to the acute exacerbation of chronic obstructive pulmonary disease with malnutrition.MethodsProspective selection 120 cases were diagnosed as AECOPD patients with malnutrition of the Department of respiratory medicine from June 2015 to August 2016,Were randomly divided into EN group and combination group, 60 cases in each group, EN group with high fat and low sugar EN liquid Omega and ω3 Yu You Zhi Fang Ru Zhu She Ye and N(2)-L-alanyl-L-glutamine for Injection, Combined group in the EN group based on the added benefits of lung spleen, compared the Nutritional status and immune function between the two groups.ResultsTwo groups of patients were successfully completed 14d treatment, After treatment, BMI, TSF, MAMC, TP, ALB, PA, HGB, TFN, NB levels were significantly higher than those before treatment (P<0.05);Combined group after treatment, the level of each index was significantly higher than the EN group (P<0.05).WBC, hs-CRP, IL-6, TNF-α levels in the two groups were significantly lower than before treatment, TLC, IgA, and IgG levels were significantly higher than before treatment (P<0.05);the combination group WBC, hs-CRP, IL-6, TNF-αlevel lower than the EN group, TLC, IgA, IgG level higher than the EN group (P<0.05).ConclusionBenefit lung and spleen strengthening traditional Chinese medicine combined with enteral nutrition can improve the nutritional status, respiratory function and immune function in patients with acute exacerbation of chronic obstructive pulmonary disease, and has high application value.
RESUMO
Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and oxygen metabolism in patients with septic shock.Methods A prospective observational study was carried out in 69 patients with early septic shock within 24 hours.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen (PtcO2) and transcutaneous carbon dioxide (PtcCO2) was monitored and the changes of hemodynamic data,tissue oxygen,microcirculation before and after reaching the criteria of EGDT were recorded.Results Compared with that before treatment,PtcO2,tissue oxygenation index (PtcO2/FiO2) after EGDT was increased [(78.1 ± 30.8) mmHg (1 mmHg =0.133 kPa) vs.(62.8 ± 24.1) mmHg and (141.7 ± 78.3) mmHg vs.(110.8 ± 60.5) mmHg],PtcCO2 and percutaneous arterial carbon dioxide partial pressure difference was decreased[(29.0 ±4.1) mmHg vs.(39.1 ±6.4) mmHg and (1.4 ±0.5) mmHg vs.(1.7 ±0.8) mmHg],there was significant difference(P＜ 0.05).There was no significant difference in PtcO2,PtcO2/FiO2,PtcCO2,central venous blood oxygen saturation,lactic acid,oxygen and oxygen consumption (P ＞ 0.05).Conclusion EGDT can improve local tissue perfusion and microcirculation in patients with septic shock,body tissue perfusion index before and after EGDT may not be able to reflect the local tissue perfusion.