早期肠内营养结合控制血糖治疗多发伤的临床疗效  

Clinical observation on multiple trauma treated by blood glucose control and early enteral nutrition

作　　者：覃炳军[1] 曾晖[1] 李燕霞[1] 

机构地区：[1]广东省东莞市人民医院,523000

出　　处：《中国实用医刊》2016年第4期44-45,共2页Chinese Journal of Practical Medicine

基　　金：广东省东莞市科技项目（B200626）

摘　　要：目的：探讨早期肠内营养（EN）结合控制血糖治疗多发伤的临床效果。方法将东莞市人民医院ICU 收治的90例严重多发伤患者按照配对分组原则，随机均分为实验组和对照组，实验组患者采取常规治疗﹢早期EN ﹢控制血糖，对照组仅采取常规治疗，比较两组患者入院时、72 h 及第7天血糖及 CRP 水平，同时对患者进行APACHEⅡ评分、住 ICU 时间及住 ICU 费用比较，记录两组患者28 d 感染率、MODS 发生率及死亡率。结果两组患者血糖和 CRP 水平均呈现明显下降趋势，与入院时比较，差异均具有统计学意义（P ﹤0.05）；实验组患者发病72 h及第7天血糖控制水平明显低于对照组，实验组患者发病第7天 CRP 水平明显低于对照组，差异均具有统计学意义（P ﹤0.05）；试验组患者第7天 APACHEⅡ评分、住 ICU 平均时间及住 ICU 平均费用均明显低于对照组，差异具有统计学意义（P ﹤0.05）；28 d 实验组患者严重感染、MODS 及死亡例数均明显少于对照组，但两组比较，差异未见统计学意义（P ﹥0.05）。结论采取早期肠内营养结合控制血糖治疗多发伤能够有效减轻患者应激反应程度，缩短康复时间，降低治疗费用，减少并发症发生率及病死率，临床效果显著。Objective To investigate the clinical observation on multiple trauma treated by blood glucose control and early enteral nutrition. Methods Ninety patients with multiple trauma were randomly divided into two groups. The treatment group was treated by convention treatment ﹢ tight glucose control ﹢ EN,the control group was treated by conven-tion treatment. The blood glucose and CRP level on admission,72 h and one week were compared,the score for APACHEⅡ,length of stay and hospitalization expenses were compared. The infection rate,MODS rate and mortality were com-pared. Results The blood glucose and CRP level were declined obviously,there was significant difference with the prior treatment on admission between the two groups（P ﹤ 0. 05）. The blood glucose level for incidence 24 h and one week were lower than that of the control group（P ﹤ 0. 05）,the CRP level for incidence one week were lower than that of the control group（P ﹤ 0. 05）;The APACHEⅡ,length of stay and hospitalization expenses were lower than those of the control（P ﹤0. 05）;The infection rate,MODS rate and mortality were lower than those of the control,but there was no significant difference between the two groups（P ﹥ 0. 05）. Conclusions Blood glucose control and early enteral nutrition in treatment of multiple trauma can improve the stress reaction,shorten recovery time,reduce cost. It can reduce the morbidity of com-plications and fatality rate,and has significant clinical effect.

关 键 词：控制血糖 早期肠内营养 多发伤 

分 类 号：R473.6[医药卫生—护理学]