肠内营养联合经肠道补充谷氨酰胺在危重患者中的随机对照研究  

Randomized comparative study on enteral nutrition combined glutamine supplement by gut in severe ill patients

作　　者：杨玉平[1] 任玉兰[1] 拓宽前[1] 李嵘[1] 佐小华[1] 

机构地区：[1]新疆维吾尔自治区克拉玛依市中心医院营养科,克拉玛依834000

出　　处：《中国实用医刊》2008年第17期10-11,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨经肠道补充谷氨酰胺对危重患者的蛋白合成、肠屏障功能的维护作用。方法选择危重患者148例，随机分为肠内营养组（对照组），肠内营养联合经肠道补充谷氨酰胺组（试验组），添加谷氨酰胺的肠外营养组（阳性对照组），予以等氮、等热量营养支持，观察营养治疗7d后肝肾功能、营养指标及肠屏障功能变化。结果三组患者营养指标及肠屏障功能均有改善，试验组变化最明显，无肝肾功能损害；对照组和阳性对照组差异无统计学意义。结论肠内营养联合经肠道补充谷氨酰胺安全、有效。可促进危重患者蛋白合成，改善营养状况，减轻应激反应，明显改善肠黏膜屏障功能，减少住院费用。Objective To explore the effective of enteral nutrition （EN） with glutamine supplement by gut in severe ill patients. Methods One hundred and forty - eight severe ill patients were performed randomized the treatment of conventional EN （control group, n = 48 ） , EN ＋Gln（ trial group, n = 50） , PN ＋Gln（ positive control group, n = 50） to evaluate the difference among plasma pre - albumin, total lymphocyte count, diamine oxidase, C reactive protein, liver and renal function at the 7th day. Results All patients＇ nutritional state and intestinal barrier function were improved, but the trial group improved most significantly. There was no obvious difference between the control group and positive control group. Conclusion EN combined glutamine supplement by gut is safe and effective in severe ill patients. It can promote the synthesis of protein, lessen stress reaction, improve nutritional state and intestinal barrier function. It may also decrease obviously the cost of hospitalization.

关 键 词：肠内营养 肠外营养 谷氨酰胺 二胺氧化酶 肠屏障功能 

分 类 号：R45[医药卫生—治疗学]