应用合理热能肠外营养治疗高龄病人全身炎症反应综合征

A study on suitable energy of parenteral nutrition with for octogenarian patients with systemic inflammatory response syndrome

目的 :探讨以基础能量消耗 (BEE)的不同倍数提供热能进行肠外营养 (PN)治疗高龄全身炎症反应综合征(SIRS)病人的效果。 方法 :采用随机对照方法 ,将 2 4例高龄 SIRS病人分为两组 ,一组 PN时按 BEE的 1.2倍提供热能 ,另一组按 BEE的 1.5倍提供热能 ,均治疗 6天。 结果 :两组在改善血清蛋白和氮平衡方面的效果相同 ;1.2 BEE组 PN支持的代谢性并发症发生率为 8.33% (1/ 12 ) ,1.5 BEE组为 5 8.3% (7/ 12 ) (P<0 .0 5 ) ;两组 PN后 APACHE 评分均下降 (P<0 .0 5 ) ,1.2 BEE组 APACHE 评分下降较 1.5 BEE组显著 (P<0 .0 5 ) ;1.2 BEE组多器官功能衰竭 (MOF)发生率 2 5 .0 % (3/ 12 ) ,1.5 BEE组为 41.7% (5 / 12 )。 结论 :应用 PN治疗高龄 SIRS时以 BEE的 1.

Objectives:To investigate the effect of PN support with different times of BEE in octogenarian patients with systemic inflammatory response syndrome(SIRS). Methods:24 octogenarian patients with SIRS were involved in a randomized control clinical trial.12 cases were treated with PN support with 1.2×BEE of total energy intake,and another 12 cases with 1.5×BEE of total energy intake for 6 days. Results:There were no significant differences in increasing serum transferrin and improving nitrogen balance between 2 groups( P >0.05).Incidences of PNs metabolic complications in 1.2×BEE group and in 1.5×BEE group were 8.33%(1/12) and 58.3% (7/12) respectively( P <0.05).The descent of APACHEⅡ score in 1.2×BEE group was more obvious than that in 1.5×BEE group( P <0.05).The incidence of MOF was 25.0%(3/12) in 1.2×BEE group and 41.7%(5/12) in 1.5×BEE group. Conclusions:This study suggests that total energy with 1.2×BEE is more suitable than that with 1.5×BEE when PN support is used in octogenarian patients with SIRS.