标准肠外营养加谷氨酰胺对治疗危重症临床结局的影响

Effect of glutamine-supplemented standard parenteral nutrition on short-term outcome in critically ill patients:a prospective randomized controlled study

目的探讨肠外营养加谷氨酰胺对重症患者近期临床结局的影响。方法采用前瞻性、随机、对照临床实验,应用随机排列表将患者分为观察组和对照组,观察两组患者的近期临床结局。结果与对照组相比,观察组在ICU停留时间明显缩短(P<0．05)．住ICU期间感染发生率明显降低(P<0．05),但病死率无明显下降。结论肠外营养加谷氨酰胺可明显降低ICU重症患者院内感染发生率并缩短在ICU停留时间,但不能降低病死率。

Objective To study the effect of glutamine-supplemented standard parenteral nutrition（PN） on short-term outcome in critically ill patients in the intensive care unit（ ICU）. Methods＇ 102 male and female critically ill patients with indications for PN and a stay on ICU for ≥7 days were randomly divided into the group of standard PN（standard group, n = 49） and the group of glutamine-supplemented PN（glutamine group, n = 53）. Target values for energy supply in both groups were 30kcal/kg per day and the values of L-alanyl-L-glutamine support in glutamine group were 0.5g/kg per day. Short-term clinical outcome was measured by rates of infectious complication, mortality and average length of stay in ICU. Results The improvemence of nutrition, vital variables anct biochemical data was similar in both groups. Compared with standard group, there was a lower infectious complication rate and shorter ICU stay without any adverse effct on mortality in glutamine group. Conclusion In critically ill patients, glutamine supplementation can reduce infectious complication and shoter ICU stay. bm can＇ t decrease case fatality rate.