生长激素合并低热量营养支持对多器官衰竭患者的影响和护理

Study on Effect and Nursing of Combining Human Growth Hormone with Hypocaloric Nutrition Support to Treat Patients with Postoperative MOF

目的探讨生长激素合并低热量肠外营养对多器官衰竭患者的影响和护理措施。方法60例术后多器官衰竭患者分为对照组(30例)和实验组(30例),术后48h至16d为观察时期,2组患者术后治疗和营养支持方案相同。实验组术后48h开始加用rhGH(8U/d)皮下注射,连续14d。监测所有患者治疗前后营养指标和营养耐受性指标,同时记录胰岛素应用情况、并发症及临床结果。结果在营养指标及氮平衡方面,2组有显著性差异,在耐受性指标方面,实验组血糖明显升高,与对照组比较,有显著性差异;对照组并发症发生率及病种高于实验组。结论低热量TPN与rhGH联合应用,能够迅速有效纠正多器官衰竭患者的营养代谢障碍,提高血浆蛋白含量,降低并发症的发生率和病死率,改善危重患者预后。

Objective To investigate the effects and nursing of combining human growth hormone （rhGH） with hypocaloric nutrition support （HNS） to treat patients with postoperative MOF. Methods Patients with 60 postoperative MOF were divided randomly into two groups and 30 cases in each group. Both of them received standard treatment. In addition,8U/d rhGH was percutaneous injected in patients of experimental group after operation 48 hours and lasted for 14 days. The patients＇ serum prealbumin,albumin, transferrin and nitrogen balance were observed before and after treatment. Clinical outcomes,blood sugar and insulin were also recorded. Results There were significant differences be- tween two groups in nutrition indexes and body nitrogen balance. Blood sugar of experimental group was higher than that in contral group and the difference was significant. The occurring rate and sort of complication in contral group was more than that in experimental group. Conclusions rhGh and hypocaloric nutritional support can improve the clinical outcome significantly, decrease the incidence of complications of postoperative MOF patients.