重症患者强化肠内营养支持的临床研究
Clinical study of enhancing the delivery of enteral nutrition in critically ill patients
李亚轻 1任珊 2王彦霞 1牛占丛 1赵鹤龄2
作者信息
- 1. 050000 河北 石家庄,河北省人民医院感染性疾病科
- 2. 050000 河北 石家庄,河北省人民医院重症医学科
- 折叠
摘要
目的 探讨早期达到肠内营养目标需求量的喂养方式对重症患者的临床应用价值.方法 采用随机数字表法将80例危重症患者分为两组,即对照组和治疗组(每组各40例).对照组提供早期常规肠内营养方式,即从小剂量开始逐渐增加剂量至目标热量供应;治疗组提供早期足量肠内营养,应用促胃肠动力药,提高胃残余量阈值至目标热量供应.由不明分组情况的医务人员观察记录指标,观察时间为3~7 d,记录白蛋白、前白蛋白、机械通气时间、入住ICU时间、住院时间,以及恶心呕吐、腹胀、腹泻的发生情况,计算恶心呕吐、腹胀、腹泻的发生率.结果与对照组比较,治疗组白蛋白、前白蛋白水平升高,且机械通气时间、入住 ICU 时间缩短(P <0.05).两组患者腹胀、腹泻的发生率比较差异无统计学意义 (P>0.05).结论 应用促胃肠动力药,提高胃残余量阈值,可早期达到重症患者能量供应目标,改善其营养状态,缩短机械通气时间和入住ICU时间,且未增加相关并发症的发生率.
Abstract
Objective To explore the value of early enough feeding in clinical application. Methods Eighty critically ill patients were randomly divided into 2 groups, namely treatment group (early enteral nutrition,application of prokinetic agents, improving gastric residual threshold) and the normal control group,with 40 patients in each group.Nutrition supporting treatment lasted for 3~7 days, blood routine and biochemical indexes (albumin, prealbumin) were recorded before application of enteral nutrition,the application of enteral nutrition after third days, the application of enteral nutrition after seventh days, the incidences of abdominal distension, diarrhea and other complications were recorded,and the time of mechanical ventilation, ICU occupancy days were recorded. Results After nutritional therapy,serum albumin,prealbumin of the treatment group was significantly higher than that in the control group,the difference was statistically significant (P<0.05). The mechanical ventilation time,the length of ICU stay in the treated group were significantly shorter than the control group(P<0.05).The incidence rate of abdominal distension,diarrhea in the two groups of patients had no significant difference (P>0.05). Conclusion Early application of prokinetic agents,while improving the gastric residual threshold, can promote to reach the goal of energy supply in critically ill patients, improve the nutritional status of patients,shorten the time of mechanical ventilation,the stay of intensive care unit,without increasing the incidence of related complications.
关键词
早期肠内营养/营养目标/危重病/胃残余量/促胃肠动力药Key words
Early enteral nutrition/Nutrition goals/Critical Illness/Gastric residual/Prokinetic agents引用本文复制引用
基金项目
河北省卫生和计划生育委员会医学科学研究指令性课题(20150119)
出版年
2018
NETL
NSTL
维普
万方数据