含缓释淀粉的肠内营养对高血糖危重患者血糖的影响及护理

Influence of enteral nutrition with slow-release starch on blood glucose level of critically ill patients with hyperglycemia and related nursing

目的探讨含缓释淀粉的肠内营养(EN)对高血糖危重患者血糖的影响及安全性。方法将56例高血糖危重患者随机分为治疗组与对照组,2组均接受相同热量的EN支持治疗及规范化护理措施,治疗组采用康全力进行治疗,对照组采用能全力进行治疗。比较2组患者EN前后空腹血糖(FBG)、餐后2 h血糖(2h PG)、糖化血红蛋白(HbAlc)、血清总胆固醇(TC)、甘油三酯(TG)、白蛋白(ALB)和总蛋白(TP)水平的变化,以及不良反应的发生情况。结果 EN后,治疗组FBG及2hPG水平明显降低,而对照组FBG及2hPG水平略有升高,治疗组FBG及2hPG水平均显著低于对照组,差异有统计学意义;EN后,2组T P及A LB水平均较EN前明显升高,差异有统计学意义;2组不良反应较轻微,患者可耐受。结论 含缓释淀粉的EN配合规范化的护理措施能有效降低高血糖危重患者的血糖水平,改善营养状况,降低不良反应的发生率。

Objective To explore the influence and safety of enteral nutrition （EN） with slow-release starch on the blood glucose level of critically ill patients with hyperglycemia. Methods 56 critically ill patients with hyperglycemia were randomly divided into treatment group and control group. Patients in both groups were treated with the same caloric EN and standardized nursing mea- sures. On this basis, the treatment group was treated with TPF-DM, while the control group was treated with TPF. Indexes such as fasting blood glucose （FBG）, 2 h postprandial glucose （2 h PG）, glycated hemoglobin （HbAlc）, serum total cholesterol （TC）, triglyceride （TG）, albumin （ALB） and total protein （TP） before and after EN treatment as well as the incidence of adverse re- actions were compared between two groups. Results After EN treatment, the levels of FBG and 2 h PG in treatment group decreased significantly, while the indexes mentioned above in the control group increased slightly. The levels of FBG and 2 h PG in the treatment group were significantly lower than those in the control group; after EN treatment, TP and ALB levels in both groups in- creased obviously, which were significantly higher than the levels before EN treatment in the corre- sponding group; adverse reactions in both groups were mild, and the patients were able to tolerate. Conclusion EN with slow-release starch combined with standardized nursing measures can effec- tively decrease the level of blood glucose in critically ill patients with hyperglycemia, improve nutri- tional status and reduce the incidence rate of adverse reactions.