【摘要】 目的:观察以短肽、短肽与整蛋白混合、整蛋白配方序贯调整的肠内营养(EN)方案对老年危重症病人的营养支持效果。方法:将94例老年危重症病人随机分为两组,即对照组45例,采用整蛋白配方,浓度、剂量、滴速均按常规方法逐渐调整增加;研究组49例,第1、2天给予短肽配方百普素,3 d后给予短肽与整蛋白混合液(百普素与能全力),持续几天后逐渐过渡至完全整蛋白配方。两组必要时均以肠外营养(PN)补充以达到目标供给量。比较两组病人治疗前和治疗后第7、14天胃肠道并发症的发生率、营养状况、C-反应蛋白(CRP)、APACHEⅡ评分、胃肠功能评分以及14~28 d内的病死率等。结果:研究组病人胃肠道并发症的发生率较对照组显著降低。治疗14 d时,两组病人的前清蛋白、转铁蛋白、CRP、APACHEⅡ评分、胃肠功能评分等均较治疗前显著改善。研究组病人治疗7 d时前清蛋白较对照组显著升高,14 d时差异更加明显。研究组病人治疗14 d时转铁蛋白较对照组明显升高,治疗7 d时CRP较对照组明显下降,治疗14 d时差异更加明显。研究组病人治疗14 d时,APACHEⅡ评分、胃肠功能评分均较对照组显著降低,病死率较对照组有所下降。结论:以短肽、短肽与整蛋白混合、整蛋白配方序贯调整的EN方案,能显著地改善ICU老年危重症病人的营养状况和胃肠功能,有利于改善预后。更多还原

【Abstract】 Objective: To observe the effect of peptide formula,mixed formula of short peptide and integrin,sequential EN program on critically ill geriatric patients in ICU. Methods: With random number table,94 patients were randomly divided into the control group and research group. Nutritional status,gastrointestinal complication rates,C-reactive protein( CRP),APACHE Ⅱ score,gastrointestinal function score before the treatment and 7d and 14d after the treatment as well as the sequelae were com- pared. Results: The incidence of gastrointestinal complications in the reserch group significantly re- duced. PA,TF,CRP,APACHE Ⅱ score and gastrointestinal function score of the reserch group signifi- cantly improved. Conclusion: The sequential EN program can significantly improve the critically ill geriatric patients’ nutrition and gastrointestinal function.更多还原