早期肠内营养支持对严重多发伤患者营养状况影响的临床观察  

Clinical observation on the effect of early enteral nutrition support on nutritional status of patients with severe multiple trauma

作　　者：邵迪群 严峰[1] 杨建兵[1] 

机构地区：[1]浙江省余姚市人民医院创伤科,浙江余姚315400

出　　处：《中国现代医生》2017年第29期15-18,共4页China Modern Doctor

基　　金：浙江省余姚市人民医院院级课题(2016YA06)

摘　　要：目的分析早期肠内营养支持对严重多发伤患者恢复营养状况的影响。方法选择2016年6月~2017年5月就诊于我院TICU且ISS评分>16分的严重多发伤患者,随机选择80例分成治疗组40例(早期肠内营养支持组)和对照组40例(晚期肠内营养支持组),分别观察并记录早期肠内营养的实施情况及营养支持第1天、第7天、第21天营养结束后的血清白蛋白(ALB)和血清前白蛋白(PA)、甘油三酯(TG)的含量、皮下脂肪厚度,观察并记录营养支持后的副作用,如褥疮、感染、胃排空延迟、腹痛、腹泻及胃反流情况等。结果与对照组的患者相比,治疗组患者的肺部感染、肠道感染、泌尿系感染、褥疮、脓毒血症等并发症的发生率低于对照组,两组相比差异有统计学意义(P<0.05);早期肠内营养支持治疗可提高严重多发伤患者血清白蛋白、总蛋白等,两组相比差异有统计学意义(P<0.05)。结论早期肠内营养在严重多发伤患者中可以实施,并有助于降低感染率。Objective To analyze the effect of early enteral nutrition support on the recovery of nutritional status in patients with severe multiple trauma. Methods Patients who were admitted in the TICU with ISS score 16 points from June 2016 to May 2017 were randomly divided into two groups. 80 patients among them were divided into treatment group（early enteral nutrition group） with 40 cases and control group（late enteral nutrition support group） with 40 cases.The implementation of early enteral nutrition was observed and recorded respectively. The serum albumin（ALB）, serum pre-albumin, triglyceride（TG） content and subcutaneous fat thickness at the end of nutrition on day 1, day 7 and day21 were observed and recorded. The side effects of nutritional support such as bed sores, infection, gastric emptying delay, abdominal pain, diarrhea and gastric reflux and so on were observed and recorded. Results The incidence of complications such as pulmonary infection, intestinal infection, urinary tract infection, bed sores, and sepsis in patients in treatment group was lower than that in control group, and the difference was significant（P0.05）. Early enteral nutrition support therapy could improve serum albumin and total protein and so on in patients with severe multiple trauma,and there was statistically significant difference between the two groups（P0.05）. Conclusion Early enteral nutrition can be performed in patients with severe multiple trauma and can help reduce infection rate.

关 键 词：早期肠内营养 严重多发伤 营养支持 晚期肠内营养 

分 类 号：R641[医药卫生—外科学]