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目的探讨营养支持治疗对重症职业性三氯乙烯药疹样皮炎(OMDT)患者的临床意义。方法将56例OMDT患者随机分为综合营养组和普通膳食组,前者给予肠外营养联合肠内营养措施,后者给予肠外营养联合普通膳食(增加高蛋白质)措施。观察2组治疗前后各项指标。结果治疗1个月后,2组谷氨酸氨基转移酶、血尿素氮、血糖、血浆C-反应蛋白水平均较治疗前下降(P<0.001),血红蛋白、血浆总蛋白、血浆白蛋白、胆固醇、血钾均升高(P<0.001);综合营养组治疗后上述各项指标改善程度较普通膳食组明显(P<0.05或P<0.001)。综合治疗组治疗前后肢体肿胀、水疱渗出、大便潜血、合并感染的发生率较治疗前下降(P<0.05或P<0.01);普通膳食组治疗后除肢体肿胀发生率下降外(P<0.05),其余3个指标发生率治疗前后差异无统计学意义(P>0.05)。综合治疗组平均住院时间(85.1±22.6)d低于普通膳食组(97.6±22.0)d,差异有统计学意义(P<0.05)。结论及时合理的营养支持对促进OMDT患者皮肤、黏膜损伤创面的愈合和肝功能恢复有明显的支持作用,有利于减少并发症,缩短住院时间,改善预后。
Objective To investigate the clinical significance of nutritional support therapy in patients with severe occupational trichlorethylene dermatitis (OMDT). Methods Fifty-six patients with OMDT were randomly divided into general nutrition group and general diet group. The former was given parenteral nutrition combined with enteral nutrition, while the latter was given parenteral nutrition combined with ordinary diet (increased high protein) measures. The indexes of two groups before and after treatment were observed. Results After 1 month of treatment, the levels of glutamate aminotransferase, blood urea nitrogen, blood glucose and plasma C-reactive protein in two groups were significantly lower than those before treatment (P <0.001). The levels of hemoglobin, plasma total protein, plasma albumin, (P <0.001). The improvement of the above indexes in the comprehensive nutrition group was more obvious than that in the common diet group (P <0.05 or P <0.001). The incidence of limb swelling, blister exudation, fecal occult blood and co-infection in the comprehensive treatment group before and after treatment were lower than those before treatment (P <0.05 or P <0.01) ), The other three indicators of the rate of treatment before and after the difference was not statistically significant (P> 0.05). The average length of stay (85.1 ± 22.6) d in the comprehensive treatment group was lower than that in the normal diet group (97.6 ± 22.0) d, with significant difference (P <0.05). Conclusion Timely and reasonable nutritional support can promote the healing of wounds and the recovery of liver function of skin and mucosal injury in patients with OMDT. It is helpful to reduce the complications, shorten the hospital stay and improve the prognosis.