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目的探讨早期肠内营养(early enteral nutrition,EEN)对重度胸外伤机械通气患者康复效果的影响。方法选取哈医大四院胸外科2013年1月至2014年9月收治的60例需机械通气的重度胸外伤患者,按抽签法产生随机序列,将患者分为两组:EEN组和静脉营养(parenteral nutrition,PN)组,每组30例。比较两组患者康复情况。结果机械通气治疗第7 d和第14 d后,EEN组营养及炎症指标均优于治疗前并明显优于静脉营养(PN)组,腹泻发生率、平均住ICU时间及平均住院时间明显降低,且差异有统计学意义(P<0.05)。EEN组呼吸机相关性肺炎发生率及应激性溃疡发生率低于PN组,但差异无统计学意义(P>0.05)。结论重度胸外伤患者早期给予EEN可促进蛋白质合成,改善患者的营养状况,纠正负氮平衡,降低炎症反应,减少并发症的产生。
Objective To investigate the effect of early enteral nutrition (EEN) on rehabilitation of severe thoracic trauma patients with mechanical ventilation. Methods Sixty patients with severe chest trauma undergoing mechanical ventilation were selected from January 2013 to September 2014 in the Fourth Hospital of Harbin Medical University. Patients were divided into two groups according to the random sampling method: EEN group and intravenous nutrition group parenteral nutrition, PN) group, 30 cases in each group. The rehabilitation of two groups was compared. Results After 7 and 14 days of mechanical ventilation, the indexes of nutrition and inflammation in EEN group were better than before treatment and were significantly better than those in PN group. The incidence of diarrhea, mean ICU stay and hospital stay were significantly lower in EEN group, And the difference was statistically significant (P <0.05). The incidence of ventilator-associated pneumonia and the incidence of stress ulcer in EEN group were lower than those in PN group, but the difference was not statistically significant (P> 0.05). Conclusion Early EEN administration in patients with severe thoracic trauma can promote protein synthesis, improve the nutritional status of patients, correct the negative nitrogen balance, reduce the inflammatory reaction and reduce the incidence of complications.