重度营养不良合理肠外营养支持探讨  

Experience of Reasonable Parenteral Nutrition Support for the Severely Malnorished Patients

作　　者：阮奕[1] 万燕萍[1] 蔡威[2] 沈婉蓉[1] 陈之琦[1] 汤庆娅[2] 夏韶民[2] 

机构地区：[1]上海第二医科大学仁济医院临床营养科,上海200001 [2]上海第二医科大学新华医院临床营养中心

出　　处：《中国临床营养杂志》2002年第1期47-50,共4页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨更合理的重度营养不良肠外营养支持(parenteralnutrition,PN)的方案。方法1998年12月～2000年5月收集仁济及新华医院住院患者应用PN≥5天且体质指数(BMI)≤16患者的临床资料共40例;年龄22～105岁,平均年龄(62.8±17.2)岁;平均PN持续(25.1±22.7)天(5～120天)。结果40例患者中复查体重14例,体重增加11例,不变1例,下降2例。PN后血红蛋白、白蛋白、前白蛋白、总蛋白均有不同程度的增高,具统计学意义。支持期间肝肾功能有一定程度的改善,发生PN相关并发症4例(占10%),其中肝功能损伤1例,胆汁淤积3例。结论营养不良由于其特殊性,营养支持方案应有别于一般疾病,过度的营养支持不但不能改善其体内营养素的缺乏,反而会加重脏器的负担,唯有合理的营养支持才能改善其营养状况,同时对维持正常代谢及内环境的稳定具有积极意义。Objective To establish an ideal protocal of parenteral nutrition(PN)support in patients with severe malnutrition.Methods The authors reviewed retrospectively a total number of40patients who received PN over consecutive five days in this study and whose body mass index(BMI)were not more than16.The subjects included26males and14females,aged from22to105(average62.8±17.2).They received PN from5～120days(average25.1±22.7days).Results Of the40patients,14patients underwent a body weight measurement again,among which,weight gain was seen in11patients,one maintained his weight and two lost their weight.After PN,the hemoglobulin,albumin,pre-albumin and total protein were all enhanced less or more significently.Within the period of PN,the function of liver and kidney was improved.The PN associated complications occurred in4patients(10%),including one with liver damage and three with cholestasis.Conclusions Nutrition support for patients with malnutrition should be different from that for other patients.Reasonable nutrition support is not only helpful to improve one's nutrition status,but also have an active impact on the maintaince of stability of ones normal metablism and internal enviroment

关 键 词：肠外营养 重度营养不良 成人 

分 类 号：R459.3[医药卫生—治疗学] R591[医药卫生—临床医学]