早期不同营养支持方式对危重患者肝脏功能及炎症反应的影响  

作　　者：庞凌霄[1] 张关齐 许秋然[1] 袁永生[1] 费敏[1] 蔡文伟[1] 

机构地区：[1]浙江省人民医院,310014

出　　处：《浙江临床医学》2017年第11期2023-2024,共2页Zhejiang Clinical Medical Journal

摘　　要：目的比较不同营养支持途径在疾病早期对ICU危重患者肝脏功能及炎症指标的影响。方法回顾性分析2015年6月至2016年6月56例危重患者的临床资料，其中肠内营养组（EN组）35例，肠内及肠外混合营养组（EN＋PN组）21例，均在入科后7d内给予全肠内营养或肠内加肠外混合营养。分别记录两组患者入科第1天及第7天的谷丙转氨酶（ALT）、总胆红素（TB）、甘油三酯（TG）、白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT），及住院天数、住院相关费用、预后等并进行比较。结果两组患者入科第1天APACHEⅡ评分差异无统计学意义（P=0．95），7d内给予总热卡比较差异无统计学意义（P=0．55），第7天后两组的肝脏功能指标、住院天数比较差异均无统计学意义（P〉0．05）；但两组间炎症指标、住院相关费用、预后比较差异有统计学意义（P〈0．05）。结论ICU危重患者在肠道可耐受情况下尽可能采用肠内营养方案，可改善患者的炎症反应及预后，并减少患者经济负担。Objective To compare the impact of different nutrition support ways on the liver function and inflammation in ICU patients. Methods 56 patients＇ data from June 2015 to June 2016 in our department were retrospectively analyzed. The EN group had 35 patients, and the EN＋PN group had 21 patients. In the hospital, all 56 patients were given nutritional support within 7 days. The data ofALT, TB, TG, WBC, CRP and PCT were recorded at the first day and the seventh day in hospital of the two groups respectively. The hospitalization days, hospitalization expenses and the prognosis were compared between the two groups. Results Two groups of patients had no statistical difference （ P=0.95 ） about APACHEII score at the first day in hospital. Within 7 days of given total calories had no statistical difference （ P=0.55 ） between the two groups. The data of liver function, hospitalization days, compare had no statistical difference （/〉0.05） at the seventh day, But two groups of inflammatory biomarkers and hospitalization expenses associated with the prognosis was statistically significant （ P〈0.05 ） . Conclusion ICU patients in the gut can tolerate as much as possible under the condition of the scheme of enteral nutrition that can improve the inflammatory response and prognosis of patients, and reduce the economic burden of patients.

关 键 词：重症监护室 营养支持 肝脏功能 炎症指标 

分 类 号：R363.27[医药卫生—病理学]