不同肠内营养液对神经外科术后应激性高血糖重症患者的影响  

Influence of different enteral nutrition preparation on severe patients with stress hyperglycemia after neurosurgery

作　　者：连玉枝 LIAN Yuzhi(The Second ICU,the First Affiliated Hospital of Fujian Medical University,Fujian Province,Fuzhou350005,China)

机构地区：[1]福建医科大学附属第一医院第二重症医学科,福建福州350005

出　　处：《中国当代医药》2022年第25期58-61,共4页China Modern Medicine

摘　　要：目的研究不同肠内营养(EN)制剂对神经外科重症监护病房(NICU)重症患者应激性高血糖的控制效果。方法回顾性选取2019年8月至2020年12月福建医科大学附属第一医院神经外科NICU重症并发应激性血糖增高的64例患者为研究对象,采用随机数字表法分为对照组(32例)和观察组(32例)。对照组患者采用整蛋白型EN制剂(能全力),观察组患者采用含缓释淀粉的EN制剂(瑞代EN液),两组患者均予以营养泵经鼻胃管匀速输注。比较两组患者的平均血糖值(GLU_(ave))、最高血糖值(GLU_(max))、最低血糖值(GLU_(min))、标准差(GLU_(sd))、血糖变异系数(GLU_(cv))和高血糖发生率,记录两组患者治疗前后的血清总蛋白、白蛋白、三酰甘油、总胆固醇水平,观察两组患者的喂养不耐受发生率。结果观察组患者的GLU_(ave)、GLU_(max)、GLU_(sd)、GLU_(cv)水平和高血糖发生率均低于对照组,GLU_(min)水平高于对照组,差异有统计学意义(P<0.05)。治疗前两组的血清总蛋白、白蛋白、三酰甘油、总胆固醇水平比较,差异无统计学意义(P>0.05);治疗后两组的血清总蛋白、白蛋白水平显著高于本组干预前,差异有统计学意义(P<0.05)。治疗后两组的三酰甘油、总胆固醇水平比较,差异无统计学意义(P>0.05)。两组的喂养不耐受发生率比较,差异无统计学意义(P>0.05)。结论瑞代EN液能更好地控制神经外科NICU重症患者的血糖值和血糖波动,有效观察、评估患者的喂养耐受性。Objective To study the control effect of different enteral nutrition(EN)preparation on stress hyperglycemia in severe patients in neurosurgical intensive care unit(NICU).Methods From August 2019 to December 2020,64 severe patients with stress hyperglycemia in NICU,Department of Neurosurgery,the First Affiliated Hospital of Fujian Medical University,were retrospectively selected as the research objects.They were randomly divided into the control group(32 cases)and the observation group(32 cases)according to random number table method.Patients in the control group were treated with whole protein EN preparation(Nutrison Fiber),and patients in the observation group were treated with EN preparation containing slow-release starch(Ruidai EN solution).Patients in the two groups were given constant rate of infusion of the nutrition pump through a nasogastric tube.The levels of glusoes average(GLU_(ave)),the glusoes maximumn(GLU_(max)),the glusoes minimum(GLU_(min)),the glusoes standard deviation(GLU_(sd)),the glusoes coefficient of variation(GLU_(cv))and the incidence of hyperglycemia were compared between the two groups.The levels of serum total protein,albumin,triacylglycerol and total cholesterol were recorded before and after treatment between the two groups,and the incidence of feeding intolerance was observed between the two groups.Results The levels of GLU_(ave),GLU_(max),GLU_(sd),GLU_(cv) and the incidence rate of hyperglycemia of the observation group patients were lower than those of the control group,and the level of GLU_(min) of the observation group was higher than that of the control group,the differences were statistical significance(P<0.05).There were no significant differences in the levels of serum total protein,albumin,triacylglycerol and total cholesterol between the two groups before treatment(P>0.05).The levels of serum total protein,albumin of the two group after treatment were higher than before treatment,the differences were statistical significance(P<0.05).There were no significant differences in

关 键 词：术后应激性高血糖 重症患者 肠内营养液 瑞代EN液 

分 类 号：R472.3[医药卫生—护理学]