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目的探讨谷氨酰胺肠内营养对急诊脓毒症合并低蛋白血症患者的临床效果。方法将2013年1月-11月收治的86例急诊脓毒症合并低蛋白血症患者随机分为治疗组和对照组各43例,对照组患者给予常规对症支持治疗,治疗组患者在对照组的基础上给予谷氨酰胺肠内营养治疗,比较两组患者治疗第7、14、28天的炎症指标、白蛋白水平、急性生理与慢性健康Ⅱ评分以及简化急性生理Ⅱ评分、病死率、住院时间等,综合分析两组患者的临床疗效。结果治疗组患者的炎症指标(白细胞计数、C-反应蛋白、降钙素原水平)与对照组比较均逐渐下降,而血浆白蛋白水平均逐步回升(P<0.05);治疗组住院时间为(20.22±6.04)d,明显低于对照组住院时间(26.18±8.24)d,差异有统计学意义(P<0.05);而在第7、14、28天时,治疗组患者的治愈率、病死率及并发症的发生率与对照组并无明显差别。结论外源性补充谷氨酰胺对急诊脓毒症合并低蛋白血症患者具有较好的临床疗效,能够显著抑制炎症反应并缩短住院时间。
Objective To investigate the clinical effect of glutamine enteral nutrition on patients with acute sepsis and hypoproteinemia. Methods A total of 86 patients with acute sepsis and hypoproteinemia admitted from January 2013 to November 2013 were randomly divided into treatment group (43 cases) and control group (43 cases). Patients in the control group received conventional symptomatic supportive therapy. Patients in the treatment group Glutamine enteral nutrition was given on the basis of comparison. The inflammation index, albumin level, Acute Physiology and Chronic Health Ⅱ score, and simplified acute physiology Ⅱ score, mortality, hospitalization were compared between the two groups on the 7th, 14th and 28th days Time, a comprehensive analysis of the clinical efficacy of two groups of patients. Results The index of inflammation (white blood cell count, C-reactive protein, procalcitonin level) in treatment group decreased gradually compared with that in control group, and plasma albumin level rose gradually (P <0.05). The hospitalization time in treatment group was ( 20.22 ± 6.04) d, which was significantly lower than the control group (26.18 ± 8.24) d, the difference was statistically significant (P <0.05); on the 7th, 14th and 28th days, the cure rate and mortality rate And the incidence of complications and control group no significant difference. Conclusion Exogenous glutamine supplementation in patients with acute sepsis and hypoproteinemia has better clinical efficacy, can significantly inhibit the inflammatory response and shorten the hospital stay.