早期肠内营养对多发肋骨骨折合并急性呼吸窘迫综合征患者预后的影响  

Effect of early enteral nutrition on prognosis of patients with multiple rib fractures combined with acute respiratory distress syndrome

作　　者：辛燕[1] 常智忠[1] 李国新 李奇林[2] 

机构地区：[1]石家庄市第三医院重症医学科,河北050011 [2]南方医科大学珠江医院急诊科,广州510280

出　　处：《中华卫生应急电子杂志》2015年第3期202-205,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

摘　　要：目的探讨早期肠内营养对严重胸部创伤致多发肋骨骨折并发急性呼吸窘迫综合征(ARDS)患者预后的影响。方法回顾分析2010年6月至2014年7月收治的126例严重胸部创伤致多发肋骨骨折并急性呼吸窘迫综合征患者,按开始给予肠内营养时间的早晚随机分为A组(n=63,进入ICU后24~48 h内给予肠内营养)和B组(n=63,进入ICU后>48 h给予肠内营养),两组其余治疗方法均相同,对其高血糖发生率、应激性溃疡发生率、肺部感染发生率进行比较。结果 A组在高血糖发生率(7/63)11%、应激性溃疡发生率(8/63)13%、肺部感染发生率(52/63)83%、B组高血糖发生率(18/63)29%、应激性溃疡发生率(20/63)32%、肺部感染发生率(60/63)95%、A组明显低于B组。结论对于严重胸部创伤致多发肋骨骨折并急性呼吸窘迫综合征患者,早期肠内营养可降低高血糖发生率、应激性溃疡发生率、肺部感染发生率,利于改善患者预后。Objective To explore the effect of early enteral nutrition on the prognosis of patients with multiple rib fractures combined with acute respiratory distress syndrome( ARDS). Methods A retrospective analysis was conducted on 126 patients with severe chest trauma caused by multiple rib fractures and acute respiratory distress syndrome treated from June 2010 to July 2014. The patients were randomly divided into Group A( n = 63,treated with enteral nutrition within 24-48 h after ICU stay) and Group B( n = 63,treated with enteral nutrition 48 h after ICU stay). The rest of the treatment was the same in both groups. The incidence of high blood sugar,stress ulcer and pulmonary infection was compared between two groups. Results The incidences of high blood sugar,stress ulcer and pulmonary infection were 11%( 7 /63),13%( 8 /63)and 83%( 52 /63) respectively in Group A but were 29%( 18 /63),32%( 20 /63) and 95%( 60 /63)respectively in Group B. Conclusion For patients with severe chest trauma induced multiple rib fractures combined with acute respiratory distress syndrome,early enteral nutrition can decrease the incidence of high blood sugar,stress ulcer and pulmonary infection and hence improve the prognosis of patients.

关 键 词：肠内营养 多发肋骨骨折 急性呼吸窘迫综合征 预后 

分 类 号：R683.1[医药卫生—骨科学] R563.8[医药卫生—外科学]