连续性肾替代治疗肾衰竭患者肠外营养支持时机的选择  

Effects of parenteral nutrition in different administration methods on the treatment of CRRT

作　　者：黄健平[1] 

机构地区：[1]什邡市人民医院肾内科,四川什邡618400

出　　处：《国际泌尿系统杂志》2016年第2期240-242,共3页International Journal of Urology and Nephrology

摘　　要：目的 探讨不同肠外营养（TPN）给药时机对外科危重患者连续性肾替代治疗（CRRT）患者营养状态的影响.方法 筛选2014年1月至2015年1月本院SICU内因严重外科创伤或脓毒症引起肾功能衰竭患者80例,所有患者APACH Ⅱ＞10,且均拟行CRRT进行治疗,采用随机数表法将其分为早期组与晚期组,其中早期组于CRRT同时行TPN治疗,晚期组于CRRT治疗后给予TPN,采集两组患者肾替代后血浆标本测量氨基酸滤过率以及肌酐清除率并比较.结果 两组肌酐清除率比较无显著差异（P＞0.05）;氨基酸滤过率比较中早期组患者滤过率明显高于对照组（P＜0.05）,差异具有统计学意义.结论 CRRT治疗同时行TPN患者营养物质虽然可被滤器滤出,但患者血浆中营养物质剩余量仍较高,CRRT同期进行TPN支持可有效对AKI患者进行营养支持,因此早期肠外营养给药方式同样可作为CRRT患者滤过首选方式.Objectives To explore the effect of different parenteral nutrition （TPN） dosing time on critical surgical patients of continuous renal replacement therapy （CRRT） influence the nutritional status of patients.Methods 80 cases of renal failure induced by severe surgical trauma or sepsis were collected from January 2014 to January 2015 in our SICU.All patients with APACH Ⅱ type 〉 10 were performed CRRT,and,randomly divided into early and late group.According to plasma specimens after renal replacement therapy,the amino acid filtration rate and creatinine clearance rate were compared between two groups.Results There was no difference in creatinine clearance rate between the two groups （P 〉 0.05）.The amino acid filtration rate in group of patients with early filtration rate was significantly higher than the control group（P 〈0.05）.Conclusions Although the nutrients in CRRT by combination of TPN therapy for AKI patients was filtered out,the rest of nutrients in plasma of patients was still high.CRRT by combination of TPN therapy for AKI patients can be used in nutrition support.So we think using early PN to CRRT patients is the preferred way of filtration.

关 键 词：肾功能衰竭 肾替代疗法 胃肠外营养 

分 类 号：R692.5[医药卫生—泌尿科学]