【摘要】 目的:研究早期EN支持对危重症病人营养状况和耐受性的影响。方法:将64例危重症病人随机分成标准EN(瑞素)组和采用高纤维素、高蛋白质EN(瑞先)治疗组,每组32例。观察病人EN支持第7和第14天后的营养状况、相关并发症和耐受性。结果:与治疗前比较,瑞先组治疗第7和第14天后,血清蛋白质水平、肌酐升高指数、氮平衡、淋巴细胞计数和APACHEⅡ评分等均有显著性差异(P<0.05),且明显优于治疗后的瑞素组水平。瑞素组病人治疗第14天后,血清蛋白质水平、氮平衡和APACHEⅡ评分等均较治疗前明显改善(P<0.05)。瑞先组病人EN期间胃肠道并发症、过渡至TEN时间均显著少于瑞素组(P<0.05)。瑞先EN组病人在14 d内100%实现TEN,而瑞素组病人仅有87.5%实现TEN。结论:危重症病人早期使用等渗、高纤维素、高蛋白质EN支持治疗,可减少胃肠道并发症,提高抗感染能力和耐受性,改善病人的营养状况。更多还原

【Abstract】 Objective: To evaluate the effect of early enteral nutrition(EN) on nutritional status and tolerance in ICU patients. Methods: 64 cases of critically ill patients were randomly divided into standard EN group(Fresubin,SSPC,32 cases) and high cellulose and high protein EN group(Fresubin Energy Fiber,SSPC,32 cases).The nutrition status,gastrointestinal complication and EN tolerance were measured before and 7 and 14 after days EN treatment. Results: The levels of serum total protein,albumin,hemoglobin,creatinine-height index,nitrogen balance,lymphocyte count,Jeukocyte count,and APACHE Ⅱ were ameliorated significantly in patients of Fresubin Energy Fiber EN treatment(P<0.05 vs.before treatment).The gastrointestinal complication and the transition time of TEN were significantly decreased in Fresubin Energy Fiber EN group compared with standard group. Conclusion: Early EN treatment with the isotonic,high cellulose and high protein nutrient,such as EN Fesubin Energy Fiber,is helpful to reduce gastrointestinal complication,to enhance the anti-infection capability and EN-related tolerance,and to improve the nutrition status in critically ill patients.更多还原