ICU危重病人使用短肽肠内营养剂不同鼻饲时间对血糖影响的研究

Impact of different peptide nasogastric enteral nutrition agent's time on blood glucose for critically ill patients in ICU

目的探讨使用短肽肠内营养剂对重症医学科（ICU）危重病患者血糖的影响。方法对60例进行肠内营养支持的ICU危重症患者随机分为两组：两组在积极治疗原发病的基础上,A组30例病人：营养液每日鼻饲持续时间16 h肠内营养泵匀速泵入;B组30例病人：营养液每日间断鼻饲12 h肠内营养泵匀速泵入进行临床随机对照研究,时间为7~27天,绝大多数为10~14天。治疗过程中,监测血糖、生化等指标,找出适合ICU患者的最佳鼻饲持续时间。结果 A组：每日鼻饲持续时间16 h的ICU危重症患者,血糖能较平稳控制;B组：每日间断鼻饲12 h的ICU危重症患者,血糖波动较大。结论通过临床观察,对ICU危重症患者进行肠内营养支持以持续泵入肠内营养液时间在10 h,使用营养液7-14天,血糖波动较小,胃肠道并发症的发生率,生化学指标改善与间断泵入营养液比较对血糖影响较大,胃肠道并发症的发生率、生化学指标改善差异有意义（P〈0.05）,APACHEⅡ评分与血糖有相关性,持续泵入营养液血糖控制较稳定,两组比较差异有意义,（P〈0.05）。经过我们研究说明肠内营养液支持治疗以持续泵入疗效较好,可缩短在ICU的住院时间,预后较好,因病例较少有待进一步研究。

Objective To investigate the impact of different peptide nasogastric enteral nutrition agent＇s time on blood glucose for critically ill patients in ICU. Methods 60 patients were randomly divided into two groups. On the basis of the active treatment of primary diseases, the group A （n = 30） was given nutrient solution nasogastric enteral nutrition for 16 hours daily, and the group B was given intermittent nasogastric enteral nutrition for 12 hours daily. The treatment course was 7 to 27 days. The course of treatment, blood glucose monitoring, biochemical indicators were observed to identify the best time for patients in ICU. Results The blood sugar was smoother in the group A than in the group B. Conclusion Through our clinical observations, enteral nutrition support continuous infusion of enteral nutrition for 10 hours, 7 - 14 days is the best for critically ill patients in ICU, which has smooth blood glucose and low incidence of gastrointestinal complications （ P 〈 0.05 ）.