肠内营养混悬液在重症胸部创伤患者中的早期应用  

Early application of enteral nutrition suspension to patients with severe chest trauma

作　　者：丁盛[1] 张小虹 向可翠[1] 梁瑜[1] 

机构地区：[1]成都军区总医院重症监护病房 [2]解放军77100部队门诊部

出　　处：《西南国防医药》2013年第1期52-54,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的观察肠内营养混悬液(TPF-FOS)在重症胸部创伤患者早期肠内营养(EN)治疗中的疗效和安全性。方法 2010年1月～2012年1月,将收治的48例重症胸部创伤患者随机分成观察组和对照组,观察组于入住ICU 48 h内开始EN治疗(经鼻饲管给予TPF-FOS),对照组则在入住ICU 48 h后开始EN治疗,达到目标喂养量125.52 kJ(30 kcal)/(kg.d)至少3 d,观察患者入住ICU后1、3、5、7、10 d的血清蛋白水平、胃肠道不良反应发生率、机械通气时间、平均ICU住院时间等,并记录不良事件。结果早期EN支持后第7 d及第10 d,观察组血清前白蛋白水平明显优于对照组(P<0.05);第1 d至第10 d两组间血清白蛋白与转铁蛋白水平均无显著差异。两组间胃肠道反应发生率无显著差异,观察组的机械通气时间、平均ICU住院时间均少于对照组(P<0.05)。结论重症胸部创伤患者早期管饲TPF-FOS可使血清前白蛋白水平及早得到恢复,尽早改善患者的营养状态,缩短患者机械通气和ICU住院时间。Objective To observe the efficacy and safety of enteral nutrition suspension （total protein fiber fruto - oligosaccharide, TPF - FOS）in the early enteral nutrition（EN） treatment of patients with severe chest trauma. Methods From January 2010 to January 2012,48 patients with severe chest trauma were randomly divided into observation group and control group. The observation group began to receive the EN treatment within 48 hours after the admission to ICU （ receiving TPF - FOS via nasogastric feeding tube） ,while the control group began to receive the EN treatment 48 hours after the admission to ICU. A targeted content of 125.52 J（30 kcal）/（kg · d）was given at least for 3 days. Observation was made in the level of serum proteins, the incidence of gastrointestinal adverse reactions, the time of mechanical ventilation, and the average length of stay in ICU, etc, on day 1,3,5,7 and 10 after admission to ICU. And the adverse events were recorded. Results On day 7 and 10 after the early EN support, the levels of serum prealbumin in the observation group were better than those in the control group（P 〈 0.05）. From day 1 to 10, there was no significant difference in the levels of seralbumin and transferrin between the two groups. And there was no significant difference in the incidence of gastrointestinal reactions between the two groups, but the time of mechanical ventilation and the average length of stay in ICU in the observation group were all shorter than those in the control group （ P 〈 0.05 ）. Conclusion Early enteral nutrition with TPF - FOS via feeding tube in patients with severe chest trauma can make early recovery of serum prealbumin levels, improve the patients＂ nutrition status, and shorten the time of mechanical ventilation and length of stay in ICU.

关 键 词：重症胸部创伤 肠内营养 营养混悬液 血清蛋白 

分 类 号：R655[医药卫生—外科学]