肠内营养乳剂在高龄吞咽困难病人营养支持中的应用

Application of enteral nutrition emulsion in the great aged patients with dysphagia

目的:探讨肠内营养乳剂TPF对高龄伴吞咽困难病人的应用价值。方法:将60例≥80岁伴吞咽困难的病人随机分为治疗组和对照组,每组各30例。病人于入院后48 h内分别给予鼻饲肠内营养乳剂TPF(瑞先)和普通鼻饲饮食,治疗1个月后,观察两组病人的营养指标(血清清蛋白、前清蛋白、血红蛋白、体重指数)、细胞免疫指标(CD3+、CD4+、CD8+)和血液生化指标(肝肾功能、血糖)等的变化。结果:治疗组病人血清清蛋白、前清蛋白、体重指数等明显高于对照组(P<0.05);CD4+、CD4+/CD8+比值等指标明显改善(P<0.05),CD3+增加更显著(P<0.01);肝肾功能、血糖等生化指标未见明显变化(P>0.05)。结论:合理的肠内营养乳剂TPF支持治疗,能改善高龄伴吞咽困难病人的营养状况和免疫功能,促进病人康复。

Objective ： To explore the clinical feasibility and importance of the application of enteral nutrition emulsion TPF in the great aged patients with dysphagia. Methods： 60 patients above 80 years old with dysphagia were randomly divided into treatment group and control group, with 30 cases in each group. Patients received enteral nutrition emulsion （TPF）support or conventional nasogastric feeding within 48 hours after admission respectively. Treatment was maintained for 1 month. Serum albumin, prealbumin, Hb, BMI, CD3＋ , CD4 ＋ and CD8 ＋ , the liver and renal function and blood glucose were measured on admission and 1 month later. Results ： After 1-month, the levels of serum albumin, prealbumin, BMI, CD3 ＋, CIM ＋ and CD4 ＋/CD8 ＋ in treatment group were elevated. Changes of the liver and renal function and blood glucose in two group had no difference （ P 〉 0. 05 ）. Conclusion ： Application of enteral nutrition emulsion（TPF） in the great aged patients with dysphagia can improve the nutrition, immune the organ function and promote the recovery.