高血糖危重病病人的肠内营养应用

Enteral nutrition in critically ill patients with hyperglycemia

目的 :观察用不同肠内营养配方对高血糖危重病病人营养支持后血糖、血脂等的影响。 方法 :分别用安素、能全力、益力佳对 4 5例病人行相同热量的肠内营养 ,监测空腹血糖、血常规、血清钾、钠、氯、肝肾功能、前清蛋白及转铁蛋白 ,留 2 4h尿 ,测尿素氮、肌酐浓度。 结果 :鼻饲安素和能全力病人空腹血糖明显升高 ,需加用胰岛素治疗 ,而益力佳组空腹血糖波动小 ,无需加用胰岛素 (P <0 .0 5 )。三组病人肠内营养前后的血清三酰甘油和胆固醇均无明显变化。 结论 :危重病病人应该早期进行肠内营养 ,并根据病人的不同情况选用不同的肠内营养剂。

Objectives:To observe the effect of different formulas of enteral nutrition on the variety of blood glucose and blood lipid in critically ill patients with hyperglycemia. Methods:Ensure, Nutrison and Glucerna were randomly used with equal daily calorie in 45 patients receiving enteral nutrition. Fasting blood glucose, blood routine, serum potassium, serum sodium, serum chlorine, liver and kidney function, prealbumin, tranferrin, urea and creatinine in 24hr urine were monitored in all cases. Results:The fasting blood glucose was significantly increased in patients having received. Ensure and Nutrison and did need insulin treatment. The fluctuation of fasting blood glucose was less in patients who had used Glucerna and didn’t need insulin(P<0.05). The changes of triglyceride and cholesterol were not significant between groups. Conclusions:Enteral nutrition should be used in critically ill patients as possible as early. The choosing of enteral formulas is to be based on the patient’s sitnation and Glucerna is more suitable for patients with hyperglycemia.