摘要
目的探讨肠内营养时机对危重症患者肠道复苏的影响。方法选择2020年1~12月在浙江省台州医院治疗的危重症患者60例的临床资料进行回顾性分析,根据肠内营养时机分为观察组与对照组,每组各30例。观察组进入ICU 48 h内行肠内营养,对照组在入住ICU 3 d后行肠内营养。比较两组治疗前后胃肠道功能评分与血清PCT、CRP、前白蛋白(PA)、清蛋白(Alb)水平,入ICU后7 d,统计两组患者完全肠内营养例数及治疗过程中不良反应发生率。结果治疗后两组胃肠道功能评分均显著下降(P<0.001);治疗后,观察组胃肠道功能评分显著低于对照组(P<0.001)。治疗后两组的PCT、CRP均较治疗前显著下降,PA与Alb显著升高,差异有统计学意义(P<0.05);治疗后观察组的PCT、CRP低于对照组,PA与Alb高于对照组,差异有统计学意义(P<0.05)。治疗7 d后,观察组18例患者完全肠内营养,对照组7例完全肠内营养,8例完全肠外营养,两组比较,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论危重症患者早期肠内营养有利于肠道功能复苏,降低炎症指标水平,提高营养指标水平,促进患者恢复,且不增加并发症的发生。
Objective To explore the effect of timing of enteral nutrition on intestinal resuscitation in critically ill patients.Methods The clinical data of 60 critically ill patients treated in our hospital from January to December 2020 were retrospectively analyzed.The patients were divided into the observation group(n=30)and the control group(n=30)according to the timing of enteral nutrition.The observation group received enteral nutrition within 48 hours of admission to the ICU,and the control group received enteral nutrition 3 days after admission.The gastrointestinal function score,serum PCT,CRP,pre-albumin(PA),and albumin(Alb)levels before and after treatment were compared between the two groups.At seven days after ICU admission,the number of patients with complete enteral nutrition and adverse reactions during treatment was counted in the two groups.Results After treatment,the gastrointestinal function score of the two groups decreased significantly(P<0.001);after treatment,the gastrointestinal function score of the observation group was significantly lower than that of the control group(P<0.001).After treatment,the PCT level and CRP level in the two groups were significantly decreased compared with those before treatment,and the PA and Alb were significantly increased,and the difference was significant(P<0.05);after treatment,the PCT level and CRP level in the observation group were lower than those in the control group,and the PA and Alb were higher than those in the control group.The difference was significant(P<0.05).After seven days of treatment,18 patients in the observation group had complete on-site nutrition;in the control group,seven patients had complete enteral nutrition,and eight patients had total parenteral nutrition.The difference between the two groups was significant(P<0.05).There was no significant difference in the in-cidence of adverse reactions between the two groups(P>0.05).Conclusion Early enteral nutrition in critically ill patients is beneficial to intestinal function resuscitation,reducing the inflammatory index,increasing the level of nutritional index,and promoting the recovery of patients without significantly increasing the occurrence of complications.
作者
林茜茜
徐海燕
金冰静
林荣海
LIN Xixi;XU Haiyan;JIN Bingjing;LIN Ronghai(Department of Critical Care Medicine,Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University,Linhai317000,China;Emergency Department,Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University,Linhai317000,China)
出处
《中国现代医生》
2022年第8期8-11,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2019ZH062)。
关键词
肠内营养
时机
危重症患者
肠道复苏
Enteral nutrition
Timing
Critically ill patients
Intestinal resuscitation
