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目的对比自制高能膳和能全力对应激性高血糖患者血糖的影响。方法选择神经外科ICU住院的重症患者40例,随机分成高能膳组和能全力组,胃肠道适宜的情况尽早开始,连续支持10 d。观察2组患者治疗期间的血糖变化及胃肠道反应情况。结果 12组患者在给予肠内营养支持后,患者血糖均有所下降,但均未能控制平稳,高能膳组患者肠内营养后第4天与第7天、第7天与第10天间患者空腹静脉血糖有显著性差异(P<0.05);能全力组患者肠内营养后第4天与第7天间患者空腹静脉血糖有显著性差异(P<0.05);2给予肠内营养期间未出现明显胃肠道反应。结论本研究结果提示,自制高能膳对神经外科重症应激性高血糖患者血糖的控制有一定的效果,但是对于血糖波动方面控制欠佳。
Objective To compare the effects of home-made high-energy diet and blood glucose in patients with stress hyperglycemia. Methods Forty patients with intensive care unit admitted to neurosurgery ICU were randomly divided into high energy diet group and moderate energy group. Gastrointestinal tract suitable conditions started as early as possible and continued for 10 days. The changes of blood glucose and gastrointestinal reactions during the treatment in two groups were observed. Results After 12 hours of enteral nutrition support, all patients in 12 groups had decreased blood glucose, but none of the patients in the stable and high-energy diet group controlled the 4th and 7th, 7th and 10th days after enteral nutrition (P <0.05). There was a significant difference in fasting venous blood glucose (P <0.05) between the fourth day and the seventh day after enteral nutrition in patients in the full strength group. No obvious gastrointestinal reaction. Conclusion The results of this study suggest that homemade high-energy diet has some effect on the control of blood glucose in patients with severe stress hyperglycemia in neurosurgery, but the control of blood glucose fluctuations is not good.