亚低温与常温下静脉营养的比较分析

Comparison of Intravenous Nutrition under Sub-hypothermia and Normal Temperature

目的探讨在行亚低温治疗时患者合适的静脉营养方法。方法选取2011年2月至2013年2月郧县人民医院治疗的脑出血患者92例,按照入重症医学科先后顺序奇数进入行常温下治疗,为常温组,偶数行亚低温治疗,为亚低温组,每组46例,均予以静脉营养,观察达到相同的目标值时,亚低温组及常温组比较在行静脉营养时的脂肪乳、葡萄糖剂量的差异,以及在每日使用复方氨基酸12.5 g时能否达到正氮平衡。结果按照相同的目标值进行静脉营养时,亚低温组及常温组比较在行静脉营养时的日均使用葡萄糖[(145.32±52.13)g vs(151.01±75.02)g]剂量,差异无统计学意义,日均使用脂肪乳剂量[(1.11±0.43)g/kg vs(1.34±0.82)g/kg]显著地少于常温组。使用相同剂量氨基酸时均可达到正氮平衡,但亚低温组日均正氮平衡较常温组[(1.85±0.75)g vs(1.24±0.24)g]显著高于常温组,P<0.05。结论在镇静肌松下行亚低温治疗应给予足够葡萄糖供应,减少脂肪乳供应,予以常规剂量氨基酸可维持正氮平衡。

Objective To investigate the appropriate methods of intravenous nutrition for the patients under sub-hypothermic treatment. Methods A total of 92 patients with cerebral hemorrhage admitted in Yun County People＇s Hospital from Feb. 2011 to Feb. 2013 were selected, patients numbered odd in ICU order were treated under normal temperature as the normal temperature group, while patients numbered even in ICU order were treated under subhypothermiaas the sub-hypothermia group, with 46 cases in each group. All the patients were treated with intravenous nutrition, when reaching the same goal value, the dose differences of fat emulsion and glucose of the two groups, as weLl as the results of whether 12.5 g of the daily use of compound amino acid can achieve positive nitrogen balance were compared. Results To reach the same target value of intravenous nutrition, the daily dose of glucose in intravenous nutrition of the sub-hypothermia group and the normal temperature group[ （ 145.32±52.13） g vs （151.01±75.02） g] showed no significant statistical difference,the daily dose of fat emulsion of the sub-hypothermia group was much less than the normal temperature group [ （ 1.11±0.43 ） g/kg vs （ 1.34± 0.82 ） g/kg ]. Using the same dose of amino acid in the two groupscan both achieve positive nitrogen balance. But the daily positive nitrogen balance level of the sub-hypothermia group was higher than the normal temperature group[ （ 1.85 ± 0.75 ） g vs （ 1.24 ±0.24 ） g ], the difference was statistically significant （ P 〈 0.05 ）. Conclusion Treatment under sub-hypothermia can provide adequate glucose, reduce the supply of fat emulsion, and the positive nitrogen balance can be maintained under routine dose of amino acids.