自制营养餐在重症监护病房机械通气患者中的应用

Application of Self-prepared Nourishing Diet in Patients with Mechanical Ventilation in Intensive Care Unit

目的探讨重症监护病房机械通气患者应用自制营养餐的营养支持效果、经济费用及不良反应。方法将64例机械通气患者随机分为试验组和对照组各32例,试验组采用自制营养餐鼻饲,对照组采用能全力鼻饲,观察1周后两组患者的血红蛋白、白蛋白、转铁蛋白、淋巴细胞总数、上臂脂肪厚度、氮平衡、经济费用及不良反应等指标。结果 1周后两组患者各项营养学指标均有明显改善,负氮平衡转为正平衡,但试验组的正平衡、空腹血糖及转铁蛋白低于对照组,差异有统计学意义（均P〈0.01）;试验组自制营养餐的费用为（32.04±2.3）元/d,低于对照组的（103.00±0.0）元/d,差异有统计学意义（P〈0.01）;试验组患者恶心、呕吐、腹泻、高血糖、应激性溃疡等不良反应的发生率低于对照组,胃管阻塞的发生率高于对照组,差异均有统计学意义（P〈0.05）。结论以西红柿、胡萝卜、瘦肉、南瓜、绿叶青菜、鸡蛋等原料配方制成自制营养餐,营养成分搭配合理,营养支持效果明显,符合中国人的饮食习惯,不良反应的发生率相对较低,经济实惠,适合在重症监护病房机械通气患者中使用。

Objective To explore the effect of nutritional support,economic costs and adverse reactions of the self-prepared nourishing diet in patients with mechanical ventilation in intensive care unit（ICU）.Methods A total of 64 patients with mechanical ventilation were randomly divided into the experiment group（n=32） fed with the self-prepared nourishing diet and the control group（n=32） fed with nasal nutrition feeding.The hemoglobin,variants of albumin,transferrin,lymph cells,arm fat thickness（TSF）,nitrogen balance,expenses and untoward effects were evaluated after a week of the treatment.Results After one week,all the nutrition indicators of the two groups were significantly improved with a conversion from negative nitrogen balance to positive nitrogen balance.The levels of positive nitrogen balance,fasting plasma glucose and transferrin of the experiment group were significantly lower than those of the control group（P〈0.01）.The expense[（32.04±2.3）Yuan/d] of the self-prepared nutrition food was significantly lower than that[（103.00±0.0）Yuan/d] of the control group（P〈0.01）.The incidences of nausea and vomiting,diarrhea and high blood sugar,stress ulcer and other adverse events were significantly lower in the experiment group than those in the control group,while the incidence of tube obstruction of stomach was significantly higher in the experiment group than that in the control group（P〈0.05）.Conclusion The nourishing diet consists of tomatoes,carrots,meats,pumpkins,green vegetables and eggs,with optimal nutrition,significant nutritional support,relatively lower incidence of adverse reactions,economical and practical value in line with Chinese eating habits,which should be provided to the patients with mechanical ventilation in ICU.