危重症患者营养支持效果及临床结局与血清前白蛋白动态变化的临床研究  

Clinical study on the relationship between the nutritional support and clinical outcomes,and the dynamical changes of serum albumin in the critically-ill patients

作　　者：李素芬[1] 蓝英飞 王利平[1] 易华[1] 唐晓珍[1] 

机构地区：[1]桂林医学院附属医院,广西桂林541001

出　　处：《华夏医学》2015年第4期46-48,共3页Acta Medicinae Sinica

基　　金：广西自然科学基金课题资助项目(2013GXNSFAA278004);广西壮族自治区卫生厅计划课题资助项目(Z2012450);桂林市科学研究与技术开发计划课题资助项目(20120121-1-6)

摘　　要：目的:研究血清前白蛋白(PA)水平在危重症患者早期营养评价、营养支持效果及临床结局中的应用价值。方法:对160例危重症患者分为4组,每组40名,选择不同的营养支持方案。结果:4组患者经过营养支持,在治疗3d时PA及血清白蛋白(ALB)与治疗前24h比较差异无统计学意义(P>0.05),治疗7d时,差异有统计学意义(P<0.05);4组患者的临床结局组间比较差异无统计学意义(P>0.05)。结论:对于危重症患者而言,不能单凭PA的动态变化制定营养支持方案,建议采取肠内营养+早期肠外营养+或补充性肠外营养联合营养支持方法,才可获得良好的营养支持效果及临床结局。Objective： To study the application value of the serum prealbumin （PA） levels in the ear ly nutrition assessment, nutritional support and clinical outcomes in critically-ill patients. Meth tritional support programs were selected for them. Results： Patients in 4 groups had been given nu tritional support, no significant differences were found of PA and ALB at 3 d of treatment and 24 h before the treatment（P〉0.05） ; but till the seventh days, there were statistical differences between the 4 groups （P〈0.05） ; there were no statistial differences of the clinical outcomes between 4 groups（P〉0.05）.Conclusion： For critically-ill patients, nutritional support programs can not made based only on dy namie changes of PA. It is recommended that the joint approaches of early enteral plus parenteral or plus supplemental parenteral nutrition support should be taken in order to obtain good clinical nutrition support and clinical outcome.

关 键 词：重症监护病房 前白蛋白 营养支持 

分 类 号：R153.9[医药卫生—营养与食品卫生学] R452[医药卫生—公共卫生与预防医学]