CAJ | 학술논문

目的:研究肠内联合肠外营养(EN+PN)支持在危重症病人中的临床应用效果. 方法:将60例有部分或全部胃肠功能的危重症病例随机分为肠内联合肠外营养(EN+PN)支持组、完全肠内营养(TEN)支持组和完全肠外营养(TPN)支持组,每组20例,对比观察营养支持前1d及营养支持后d7患者的体重指数、肱三头肌皮褶厚度、血清前白蛋白、白蛋白、总蛋白、血红蛋白、免疫球蛋白、淋巴细胞计数,且每天观察并发症情况. 结果:营养指标比较:经EN+PN支持后,血清前白蛋白明显升高(P<0.01),总蛋白、白蛋白、血红蛋白、免疫球蛋白、淋巴细胞计数亦有升高(P<0.05);而TEN和TPN支持后,各指标结果无显著差异.三组对比,EN+PN支持组血清前白蛋白、白蛋白、总蛋白、血红蛋白、免疫球蛋白、淋巴细胞计数均高于EN组和PN组(P<0.05),体重指数,肱三头肌皮褶厚度无显著差异.并发症比较:EN+PN支持组患者并发症的发生率显著低于EN组和PN组(P<0.05).结论:EN+PN支持更符合生理状态,有更好的代谢效应,能改善危重症病例营养状况提高免疫功能,降低并发症发生率,对有部分或全部胃肠功能的危重症病例,应尽量早期采用.
목적:연구장내연합장외영양(EN+PN)지지재위중증병인중적림상응용효과. 방법:장60례유부분혹전부위장공능적위중증병례수궤분위장내연합장외영양(EN+PN)지지조、완전장내영양(TEN)지지조화완전장외영양(TPN)지지조,매조20례,대비관찰영양지지전1d급영양지지후d7환자적체중지수、굉삼두기피습후도、혈청전백단백、백단백、총단백、혈홍단백、면역구단백、림파세포계수,차매천관찰병발증정황. 결과:영양지표비교:경EN+PN지지후,혈청전백단백명현승고(P<0.01),총단백、백단백、혈홍단백、면역구단백、림파세포계수역유승고(P<0.05);이TEN화TPN지지후,각지표결과무현저차이.삼조대비,EN+PN지지조혈청전백단백、백단백、총단백、혈홍단백、면역구단백、림파세포계수균고우EN조화PN조(P<0.05),체중지수,굉삼두기피습후도무현저차이.병발증비교:EN+PN지지조환자병발증적발생솔현저저우EN조화PN조(P<0.05).결론:EN+PN지지경부합생리상태,유경호적대사효응,능개선위중증병례영양상황제고면역공능,강저병발증발생솔,대유부분혹전부위장공능적위중증병례,응진량조기채용.
Objective:To study the clinical application effect of enteral combined with parenteral nutrition support on critically ill patients. Methods: Nutrition support were analyzed in 60 critically ill patients, with 20 cases supported by enteral combined with parenteral nutrition,20 cases supported by enteral nutrition and 20 cases supported by parenteral nutrition.compared with body mass index(BMI), the thickness of triceps skin fold(TSF),serum prealbumin,albumin,total protein,hemoglobin,immunoglobulin,lymphocyte count between the day before nutritional support and the seventh day after nutritional support,and the situation of related complications were observed. Results:comparasion of nutrient parameter:It was found that serum prealbumin improved obviously (P<0.01) and albumin,total protein, hemoglobin,immunoglobulin,lymphocyte count were elevated (P<0.05) in patients with EN+PN.There was no differences in BMI and TSF. comparison of the complications:The complication rate of enteral combined with parenteral nutrition support patients is obviously lower than EN group,PN group Conclusions: Enteral combined with Parenteral nutrition support accord with physiological state and has better metabolic effect,and improve the nutritional status and immune function,reduce complication rate,In critically ill patients,enteral combined with parenteral nutrition support should be selected.