α-耐高温淀粉酶水解匀浆膳对危重症患者的营养支持

The Application of Thermostable Amylase Treated Element Diet on Nutritional Support of Patients with Critical Illness

目的探讨α-耐高温淀粉酶水解匀浆膳对危重症患者营养支持的可行性及临床效果。方法分别以传统法、水解法制作匀浆膳,对比同一黏稠度下单位体积营养成分。62例危重患者随机均分为传统法组和水解法组。手术后第3d开始等热量、等氮量(146kJ·kg-1.d-1)营养支持。分别于营养支持前及支持后第14d测量上臂围(MAC)、三头肌皮褶厚度(TSF)、上臂肌围(MAMC),检测血清总蛋白(TP)、血清白蛋白(ALB)、血红蛋白(HGB)等营养指标。结果同一黏稠度的匀浆膳单位体积营养成分含量,水解法均高于传统法,差别有统计学意义(P<0.05);营养支持14d后,2组TSF均无明显改变,水解法组MAC、MAMC、TP、ALB、HGB较传统法组明显升高,差别有统计学意义(P<0.05)。结论α-耐高温淀粉酶水解匀浆膳可提高管饲饮食临床应用的成功率,能明显改善危重症患者的营养状况。

Objective To study the feasibility and effects of thermostable amylase treated element diet on the nutritional support of patients with critical illness. Methods Thermostable amylase treated element diet was prepared by hydrolysis method, while the element diet prepared by traditional method was used as control. The main nutrients of the two methods prepared element diets were compared in the same concentration. Sixty-two patients with critical illness were randomized into hydrolytic method group （n=31） and traditional method group （n=31）. The patients in both groups accepted isonitrogenous and isocaloric（146 kJKang Qing, Guan Jinfeng, Wang Xiaolian （Department of Clinical Nutrition,The Affiliated First Hospital, Fujian Medical University, Fuzhou 350005, China）kJ·kg^-1·d^-1） nutritional support. Anthropometric and biochemistric indexes, including arm circumference （MAC）, triceps skinfold thickness （TSF）, arm muscle circumference （MAMC）, total proteins（TP）, serum albumin（ALB） and hemoglobin（HGB） were examined before and 14 d after nutritional support. Results When compared to traditional method group, the main nutrients in the same concentration were obviously higher in hydrolysis method group（P〈0.05）. 14 d after nutrition support the MAC, MAMC, TP, ALB and HGB levels in the hydrolysis method group were significantly increased（P〈0.05）, excepted TSF level. Conclusion Hydrolysis element diet is effective when administrated for enteral feeding, which may improve the rehabilitating process of patients with critical illness.