早期肠内营养与肠外营养对应激性溃疡患者C-反应蛋白水平及医院感染的影响研究  

Influence of early enteral nutrition and parenteral nutrition on C-reactive protein level and nosocomial infections in patients with stress ulcer

作　　者：吕保良 倪居[2] 潘玲[2] 张雪灵[2] 张瑞芳 

机构地区：[1]郑州铁路职业技术学院医学技术系,河南郑州451460 [2]郑州铁路职业技术学院护理学院,河南郑州451460 [3]郑州大学第五附属医院营养科,河南郑州450052

出　　处：《中华医院感染学杂志》2018年第1期62-65,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨早期肠内营养与肠外营养对应激性溃疡(SU)患者C-反应蛋白(CRP)水平及医院感染率的影响。方法选取2014年5月-2016年4月医院收治的98例SU患者为研究对象,随机分为肠内营养组与肠外营养组,每组49例,分别在常规治疗基础上给予早期肠内营养与肠外营养,比较两组患者临床治疗有效率、血清CRP水平、胃液pH以及医院感染率。结果肠内营养组治疗有效率为87.8%,高于肠外营养组的69.4%(P<0.05);两组患者治疗前CRP、胃液pH值比较差异均无统计学意义,经上述治疗后,两组患者CRP均降低,胃液pH值均增高,且治疗后肠内营养组CRP降低与胃液pH值升高幅度均优于肠外营养组(P<0.05);肠内营养组医院感染率为12.2%,低于肠外营养组的32.7%(P<0.05)。结论早期肠内营养能够提高SU治疗效果,提高胃液pH值,减轻炎症反应,降低CRP水平,降低医院感染率,值得推广。OBJECTIVE To explore the influence of early enteral nutrition and parenteral nutrition on C-reactive protein （CRP） level and incidence of nosocomial infections in patients with stress ulcer （SU）.METHODS A total of 98 SU patients who were treated in hospitals from May 2014 to Apr 2016 were recruited as the study objects and randomly divided into the enteral nutrition group and the parenteral nutrition group, with 49 cases in each group, which were respectively given early enteral nutrition and parenteral nutrition on basis of conventional treatment. The effective rate of clinical treatment, serum CRP level, pH of gastric juice and incidence of nosocomial infec- tions were observed and compared between the two groups of patients.RESULTS The effective rate of treatment of the enteral nutrition group was 87.8%, significantly higher than 69.4% of the parenteral nutrition group （P 〈0.05）.There was no significant difference in the CRP or pH value of gastric juice between the two groups of pa- tients before the treatment; after the treatment, the CRP level of the two groups of patients was reduced, while the pH value of gastric juice of the two groups of patients was increased, the amplitude of reduced CRP level of the enteral nutrition group was significantly greater than that of the parenteral nutrition group, and the amplitude of increased pH value of gastric juice of the enteral nutrition group was greater than that of the parenteral nutrition group （P〈0.05）.The incidence rate of nosocomial infection was 12.2 % in the enteral nutrition group, remarkably significantly than 32.7 % in the parenteral nutrition group （P 〈0.05）.CONCLUSION The early enteral nutrition may improve the curative effect of the SU patient, raise the pH value of gastric juice, alleviate the inflammatory response and reduce the CRP level as well as the incidence of nosocomial infections, and it is worthy to be promo-ted in the hospital.

关 键 词：肠内营养 肠外营养 应激性溃疡 C-反应蛋白 医院感染 

分 类 号：R181.3[医药卫生—流行病学]