糖尿病专用肠内营养混悬液在急性脑梗死应激性高血糖患者肠内营养中的应用  

Application of TPF-DM in enternal nutrition for acute cerebral infarction patients with stress hyperglycemia

作　　者：肖美娟[1] 殷为勇[1] 叶祖森[1] 邵蓓[1] 韩钊[2] 

机构地区：[1]温州医科大学附属第一医院神经内一科,325000 [2]温州医科大学附属第二医院神经内科

出　　处：《浙江医学》2014年第13期1159-1161,共3页Zhejiang Medical Journal

摘　　要：目的探讨糖尿病专用肠内营养混悬液(TPF-DM,商品名:康全力)在急性脑梗死应激性高血糖患者肠内营养中的有效性及安全性。方法将110例存在吞咽障碍的急性脑梗死应激性高血糖患者随机分为实验组和对照组,每组55例,分别给予TPF-DM、肠内营养混悬液(TPF,商品名:能全力)作为肠内营养制剂。监测两组患者给予肠内营养前及肠内营养后第1、7、14天的空腹静脉血糖,并观察两组治疗后第1、7、14天的营养指标血清白蛋白(ALB),血清前白蛋白(PAB),血红蛋白(Hb)含量,第14天感染并发症;同时监测两组患者的不良反应,包括腹胀、腹泻及应激性溃疡的次数。结果(1)实验组在给予TPF-DM肠内营养支持后,血糖较平稳,肠内营养前及治疗后第1、7、14天空腹静脉血糖均无统计学差异(均P>0.05);且均低于同期对照组的空腹静脉血糖(均P<0.05)。(2)实验组治疗后第14天营养指标(ALB、PAB)高于对照组(均P<0.05),低蛋白血症发生率较对照组低(P<0.05)。(3)实验组第14天感染发生率较对照组低(P<0.05),两组在给予肠内营养期间均未出现明显胃肠道反应。结论 TPF-DM可有效控制急性脑梗死应激性高血糖患者的血糖水平,减少血糖波动,改善患者营养状况,减少感染并发症。TPF-DM作为急性脑梗死应激性高血糖患者的肠内营养剂安全性高,不良反应小。Objective To investigate the effectiveness and safety of enteral nutritional suspension TPF- DM as the enternal nutritional agent for acute cerebral infarction patients with stress hyperglycemia. Methods One hundred and ten acute cerebral infarction patients with stress hyperglycemia who had dysphagia were randomly divided into experimental group and control group with 55 cases in each group. In experimental group patients received TPF- DM as the enteral nutritional agent and those in control group received TPF. Fasting blood glucose（FBG） was measured before and 1, 7 and 14 d after enteral nutrition. Serum al-bumen, prealbumin, heamoglobin were measured at d1, d7 and d14 after enrernal nutrition and the incidence of infection compli-cations was documented. Diarrhea, abdominal distention and stress ulcer were monitored in both groups. Results FBG levels in experimental group were stable before and 1, 7, 14d after treatment （P〉0.05）;FBG levels in experimental group were lower than those in control group （P〈0.05）. Serum albumin and prealbumin levels in experimental group were significantly higher than those in control group, （al P〈0.05）;a lower incidence of hypoalbuminemia was noticed in experimental group at d14 after treatment （P〈0.05 ）. The incidence of gastrointestinal adverse reactions was low in both groups. Conclusion TPF- DM is effective and safe in control ing the blood glucose, reducing blood sugar fluctuations and improving the nutritional status of acute cerebral infarction patients with stress hyperglycemia.

关 键 词：急性脑梗死 糖尿病专用肠内营养混悬液 肠内营养混悬液 肠内营养 应激性高血糖 

分 类 号：R743.3[医药卫生—神经病学与精神病学]