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作 者:刘畅 Liu Chang(Department of Critical Care Medicine,General Hospital of Western Theater Command,Chengdu,Sichuan,610083,China)
机构地区:[1]西部战区总医院重症医学科
出 处:《西南国防医药》2020年第1期16-18,共3页Medical Journal of National Defending Forces in Southwest China
摘 要:目的探讨经鼻空肠置管给予整蛋白类营养制剂对于重症急性胰腺炎患者的疗效。方法选取100例重症急性胰腺炎患者,随机分组为治疗组与对照组,对照组经鼻空肠置管给予短肽类制剂治疗,治疗组经鼻空肠置管给予整蛋白类制剂治疗。在入组第7 d,比较两组血浆白蛋白、前白蛋白、胶体渗透压、转铁蛋白、预后营养指数、氮平衡;治疗结束后,比较两组营养治疗费用:同时,比较两组病情预后指标:机械通气时间、ICU停留时间、60 d病死率。结果在治疗7 d后,治疗组的血清白蛋白、视黄醇结合蛋白、前白蛋白等营养学疗效指标优于对照组(P<0.05)。治疗组营养治疗费用为210.96元/d,对照组为255.50元/d。治疗期间,两组营养喂养不良反应发生率无显著差异(P>0.05)。与对照组比较,治疗组住ICU天数、机械通气时间更短,60 d病死率较低(P<0.05)。结论与经鼻空肠置管给予短肽类制剂相比,对重症急性胰腺炎患者经鼻空肠置管给予整蛋白类营养制剂行肠内营养治疗,能够更有效改善患者营养状况和预后,经济性更好,值得临床推广应用。Objective To explore the efficacy of administration of intact protein-based nutrition preparation by nasojejunal tube in treatment of severe acute pancreatitis(SAP).Methods A total of 100 patients with SAP were randomly divided into a treatment group and a control group.Administration of preparation with short-chain peptide and intact protein-based nutrition preparation was performed on the control group and the treatment group by nasojejunal tube,respectively.Plasma albumin,prealbumin,colloid osmotic pressure,transferrin,prognostic nutritional index(PNI)and nitrogen balance were compared between the two groups at seven days of enrollment.The cost of nutritional treatment was compared between the two groups after the treatment.Meanwhile,comparison was made between the two groups in terms of prognostic indicators,including mechanical ventilation time,length of stay in ICU,and60-day mortality.Results The indicators of nutritional efficacy such as serum albumin,retinol conjugated protein(RBP)and prealbumin in the treatment group were better than those in the control group after seven days of treatment(P<0.05).The cost of nutrition treatment in the treatment group and the control group was CNY 210.96 and CNY 255.50 per day,respectively.During the treatment,there was no significant difference in the incidence of adverse reactions to nutritional feeding between the two groups(P>0.05).Compared with the control group,the treatment group had shorter length of stay in ICU(days),shorter duration of mechanical ventilation,and lower 60-day mortality(P<0.05).Conclusion Compared with the administration of preparation with short-chain peptide by nasojejunal tube,the administration of intact protein-based nutrition preparation by nasojejunal tube in treatment of patients with SAP can more effectively improve the nutritional status and prognosis of patients,with lower economic cost,which is worthy of clinical promotion and application.
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