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目的探讨重症全身性炎症反应综合征患者营养风险筛查情况和补硒治疗效果。方法 54例重症全身性炎症反应综合征患者,其中23例存在营养不良风险,作为营养不良风险组;另31例营养正常,作为营养正常组。将营养不良风险组患者随机分为对照组(12例)和观察组(11例)。对照组采用常规治疗,观察组采用补硒治疗,比较两组营养指标、并发症和急性生理与慢性健康评分表(APACHEⅡ)评分情况。结果54例患者中23例存在营养不良风险,发生率为42.59%;营养不良风险组的BMI、血清白蛋白(ALB)、血红蛋白(Hb)和红细胞计数均低于营养正常组(P<0.05);观察组治疗后第14天的ALB、Hb高于对照组(P<0.05);观察组腹胀、腹泻、高血糖和胃肠出血等并发症发生率均低于对照组(P<0.05);观察组治疗14d后的APACHEⅡ评分低于对照组(P<0.05)。结论重症全身性炎症反应综合征患者极易发生营养不良风险,及时给予补硒治疗可有效改善患者营养状况,降低并发症发生率,促进早日康复。
Objective To investigate the screening of nutritional risk in patients with severe systemic inflammatory response syndrome and the effect of selenium treatment. Methods Twenty-four patients with severe systemic inflammatory response syndrome were included, of whom 23 were at risk of malnutrition as the risk group of malnutrition. The other 31 patients were nourished as normal nutrition group. Malnutrition risk group were randomly divided into control group (12 cases) and observation group (11 cases). The control group was treated with conventional therapy, and the observation group was treated with selenium supplementation. Nutritional indexes, complications, acute physiology and chronic health score (APACHEⅡ) score of the two groups were compared. Results Twenty-three of 54 patients were at malnutrition risk (42.59%). The malnutrition risk group had lower BMI, serum albumin (ALB), hemoglobin (Hb) and erythrocyte count than those of normal nutrition group (P <0.05) (P <0.05). The incidences of abdominal distension, diarrhea, hyperglycemia and gastrointestinal bleeding in the observation group were lower than those in the control group on the 14th day after treatment (P <0.05). The APACHE Ⅱ score of the observation group after 14 days of treatment was lower than that of the control group (P <0.05). Conclusions Patients with severe systemic inflammatory response syndrome are prone to malnutrition risk. The timely administration of selenium supplementation can effectively improve the nutritional status of patients, reduce the incidence of complications and promote early rehabilitation.