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作 者:刘炳炜[1] 胡炜[1] 胡伟航[1] 朱英[1] 王剑荣[1] 叶瑞[1] 苏俊[1]
机构地区:[1]杭州市第一人民医院ICU,浙江杭州310000
出 处:《中国中西医结合急救杂志》2018年第1期70-71,84,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
摘 要:目的 探讨瑞能在老年卧床患者肠内营养(EN)支持中的应用价值.方法 选取杭州市第一人民医院重症医学科(ICU)2015年1月至2016年1月收治的老年卧床患者40例,在常规治疗的基础上给予瑞能经鼻肠管注入进行EN,监测EN前后患者血生化指标〔血清白蛋白(Alb)、前白蛋白(PA)、总淋巴细胞计数(LYM)〕和免疫指标(IgG、IgM、IgA)的变化.结果 EN治疗10 d后患者血清Alb、PA、LYM、IgG、IgM均较治疗前显著升高,差异均有统计学意义〔Alb(g/L):30.29±1.65比28.31±1.72,PA(g/L):0.25±0.05比0.23±0.02,LYM(×109/L):1.69±0.28比1.47±0.32,IgG(g/L):11.54±0.96比10.69±0.70、IgM(g/L):1.21±0.19比0.95±0.13,均P〈0.05〕;治疗20 d后上述各指标与治疗10 d比较上升更加明显〔Alb(g/L):34.16±2.41比30.29±1.65,PA(g/L):0.28±0.03比0.25±0.05,LYM(×109/L):1.96±0.31比1.69±0.28,IgG(g/L):14.56±0.77比11.54±0.96,IgM(g/L):1.56±0.18比1.21±0.19,均P〈0.05〕,治疗后10 d、20 d IgA均较治疗前有升高趋势,但差异均无统计学意义(g/L:2.63±0.33、2.67±0.11比2.61±0.27,均P〉0.05).结论 瑞能对老年卧床患者营养状况及免疫功能的改善有重要临床意义.Objective To explore the application value of Supportan in elderly bedridden patients with enteral nutrition (EN) support. Methods Forty cases of elderly bedridden patients admitted to the Department of Intensive Care Unit (ICU) of Hangzhou First People's Hospital from January 2015 to January 2016 were enrolled, Supportan was injected through an indwelling naso-intestinal tube on the basis of routine treatment, and the changes of blood biochemical parameters of EN [serum albumin (Alb), pre-albumin (PA), total lymphocyte count (LYM)] and immune indexes (IgG, IgM, IgA) were monitored before and after EN treatment. Results Ten days after EN treatment, the serum Alb, PA, LYM, IgG, IgM were significantly higher than those before treatment, the differences being statistically significant [Alb (g/L): 30.29±1.65 vs. 28.31±1.72, PA (g/L): 0.25±0.05 vs. 0.23±0.02, LYM (×109): 1.69±0.28 vs. 1.47±0.32, IgG (g/L): 11.54±0.96 vs. 10.69±0.70, IgM (g/L): 1.21±0.19 vs. 0.95±0.13, all P 〈 0.05]; 20 days after EN treatment, above indexes were increased more significantly compared with those 10 days after EN treatment [Alb (g/L): 34.16±2.41 vs. 30.29±1.65, PA (g/L): 0.28±0.03 vs. 0.25±0.05, LYM (×109/L): 1.96±0.31 vs. 1.69±0.28, IgG (g/L): 14.56±0.77 vs. 11.54±0.96, IgM (g/L): 1.56±0.18 vs. 1.21±0.19, all P 〈 0.05], 10 days, 20 days after EN treatment, IgA shown a tendency increased, there was no statistical significant difference compared with that before treatment (g/L: 2.63±0.33, 2.67±0.11 vs. 2.61±0.27, both P 〉 0.05). Conclusion Supportan has important clinical significance in improving the nutritional status and immune function of elderly bedridden patients.
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