多发伤病人机械通气时营养支持

Nutritional support in multiple trauma patients with mechanical ventilation

目的 :探讨营养支持在治疗并发有重度肺功能障碍的多发伤病人过程中的作用。方法 :2 5例多发伤病人在实施机械通气过程中予以营养支持 ,并检测营养支持前后的营养指标 ,其中 19例早期采用全胃肠外营养 ( TPN)支持 ,6例采用肠内营养 ( EN)。结果 :痊愈 16例 ,4例转手术科室 ,3例死亡 ,2例持续植物状态。 16例痊愈者营养支持前后血红蛋白、白蛋白、血清总蛋白、转铁蛋白、氮平衡均有显著提高 ( P<0 .0 5)。结论 :合理的营养支持有助于控制多发伤病人因高代谢状态导致的营养和免疫衰竭 ,合并严重肺功能障碍而实施机械通气者平稳脱机 ,并降低死亡率及致残率。

Objective:To explore the role of nutritional support in the multiple trauma patients with severe respiratory failure.Methods:25 patients with multiple trauma were given nutritional support during being mechanical ventilated,and nutritional index was analyzed before and after nutritional support.19 cases had been treated with total parenteral nutrition (TPN) and 6 cases had been treated enteral nurtition (EN).Results:[WT5BZ]6 cases were obtained clinical cure and 4 cases were removed to other operative departments,3 cases died and 2 cases are living as persistent vegetative state.Hemoglobin,serum albumin,totle serum protein,transferrin and protein balance of 16 cure cases increased significantly after nutritional support (P<0.05).Conclusion:Reasonable nutritional support can control the multiple trauma patients nutrition and immunity failure because of hypermetabolism state,secede ventilation carmly,diminish the mortality and morbidity for the multiple trauma patients with severe respiratory failure who were given mechanical ventilation.