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目的探讨添加谷氨酰胺的肠外营养在ICU重症颅脑损伤患者中的应用效果。方法选取2012年1月—2014年1月我院ICU收治的重型颅脑损伤患者78例,将患者随机分为观察组和对照组,各39例。两组患者均给予常规对症支持治疗,在此基础上,对照组患者给予中心静脉肠外营养支持治疗,观察组患者给予添加谷氨酰胺的肠外营养支持治疗。观察两组患者治疗前后干体质量、饮食摄入评分、胃肠道状况评分、功能状态评分、中臂肌肉周径、中臂肌皮褶厚度、体质指数、血清清蛋白、载铁蛋白及营养不良-炎症评分(MIS)。结果治疗前两组患者干体质量、饮食摄入评分、胃肠道状况评分、功能状态评分、中臂肌肉周径、中臂肌皮褶厚度、体质指数、血清清蛋白、载铁蛋白及MIS比较,差异均无统计学意义(P>0.05)。治疗后观察组患者干体质量、中臂肌肉周径、中臂肌皮褶厚度、体质指数、血清清蛋白、载铁蛋白、MIS均高于对照组(P<0.05);两组患者饮食摄入评分、胃肠道状况评分及功能状态评分比较,差异无统计学意义(P>0.05)。结论将添加谷氨酰胺的肠外营养应用于ICU重症颅脑损伤患者具有良好的效果,能有效改善患者的营养状况,其可作为ICU重症颅脑损伤患者的营养供给方式。
Objective To investigate the effect of adding glutamine parenteral nutrition in patients with severe craniocerebral injury in ICU. Methods Seventy-eight patients with severe traumatic brain injury admitted to our hospital from January 2012 to January 2014 were randomly divided into observation group and control group, with 39 cases in each group. Both groups were given conventional symptomatic and supportive treatment. On this basis, patients in the control group were treated with central parenteral nutrition support and patients in the observation group were given parenteral nutrition support treatment with glutamine. The body weight, dietary intake, gastrointestinal condition score, functional status score, median muscular circumference, musculocutaneous fold thickness, body mass index, serum albumin, carrier protein and nutrition in two groups were observed before and after treatment Bad - inflammation score (MIS). Results Before treatment, the scores of dry weight, dietary intake, gastrointestinal status score, functional status score, median muscular circumference, medullary myofascial fold, body mass index, serum albumin, carrier protein and MIS There was no significant difference between the two groups (P> 0.05). After treatment, the dry weight, middle arm muscle circumference, medial arm muscle skinfold thickness, body mass index, serum albumin, carrier protein and MIS in the observation group were significantly higher than those in the control group (P <0.05). The diet of the two groups Score, gastrointestinal status score and functional status score, the difference was not statistically significant (P> 0.05). Conclusion The application of glutamine in parenteral nutrition in ICU patients with severe craniocerebral injury has a good effect and can effectively improve the nutritional status of patients, which can be used as the ICU patients with severe craniocerebral injury nutritional supply.