新型肠内营养制剂在颅脑重症患者血糖控制中的作用  

The effect of new enteral nutrient on blood glucose in patients with severe craniocerebral injury

作　　者：丘琪政[1] 刘文浩[1] 张光宇[1] 陈纪欢[1] 叶敏[1] 

机构地区：[1]梅州市人民医院神经外一科,广东梅州514031

出　　处：《泰山医学院学报》2017年第5期512-513,共2页Journal of Taishan Medical College

摘　　要：目的探讨新型肠内营养乳剂(TPF-D)与肠内营养混悬液(TPF)对颅脑重症患者血糖水平的影响。方法50例颅脑损伤后格拉斯哥昏迷评分(GCS)小于8分的患者,且这部分患者未进行手术治疗。随机均分为对照组和试验组,每组均于伤后2天内给予全肠外营养支持(TPN)。伤后2天后,对照组患者使用标准配方肠内营养支持(EN)乳剂TPF,试验组患者使用低糖类EN制剂TPF-D。观察不同EN制剂对患者空腹血糖及胰岛素用量的影响,并观察两组患者胃肠道反应的区别。结果使用4周后,TPF-D具有显著降低重症颅脑患者的血糖及胰岛素水平(P<0.05)的作用,且胃肠道反应不明显。结论 TPF-D在改善颅脑重症患者应激性高血糖状态方面优于标准配方乳剂,具有一定的推广价值。Objective ： To compare the effects of the new type of enteral nutrition on blood glucose to the general enteral nutrition support in patients with severe craniocerebral injury. Methods： Fifty patients with severe cranioeerebral injury （GCS 〈 8 ） were divided into the research group （ n = 25 ） and the control group （ n = 25 ）. The two groups were supported with total parenteral nutrition （TPN） within 48 h after injury and then were given enteral nutrition （EN） 48 h after injury. The control group was treated with standard enteral nutrition support （EN）, while the experimental group received low carbohydrate EN preparations to observe the effects of different EN preparations on blood glucose and insulin dosage, and the difference between the two groups of patients with gastrointestinal reactions. Results： After 4 weeks of use, low carbohydrate EN significantly reduced the blood glucose and insulin levels in patients with severe cranioeerebral （P 〈 0.05 ） and the gastrointestinal side reactions were not obvious. Conclusion： For the severe craniocerebral injury patients with hyperglycemia, low carbohydrate EN is better than the standard enteral nutrition support.

关 键 词：肠内营养 颅脑重症 血糖 胰岛素 

分 类 号：R459.3[医药卫生—治疗学] R651.15[医药卫生—临床医学]