脓毒症病人血液净化联合早期肠内营养的耐受性管理

The tolerance management of EEN in sepsis patients with CBP

目的：探讨外科脓毒症病人连续性血液净化（CBP）联合早期肠内营养（EEN）的耐受性管理措施。方法：将入住我科ICU诊断为脓毒症并行床旁CBP治疗的危重症病人239例分为两组。对照组（n=118）病人在生命体征平稳、肠道功能恢复后开始EN治疗;观察组（n=121）病人在入住ICU的24-48 h即开始给予EEN治疗。结果：治疗后一周,观察组病人血清清蛋白（ALB）较治疗前明显上升（P〈0.05）;总蛋白（TP）、ALB、前清蛋白（PA）显著高于对照组（P〈0.01）。观察组病人EEN耐受率达80.12%,入住ICU天数、机械通气时间与对照组比均有显著性差异（P〈0.01）。结论：脓毒症病人CBP联合EEN的同时采取耐受性管理措施,不仅可保障EEN的安全实施,而且有效地改善病人的营养指标,缩短机械通气和入住ICU时间,有利于加速病人康复。

Objective ： To explore the tolerance management measures of early enteral nutrition in sepsis patients with CBP. Methods： Two hundred and thirty-nine sepsis patients with bedside blood purification treatment were divided into 2 groups. Control group （n = 118 ）, started enteral nutrition after the intestinal function recovery and in the stable vital signs. Observation group（ n = 121 ） began with early enteral nutrition in the first rain, prealbumin and total 0.01）. The tolerance rate control group was 70.33%. 24 ~ 48 h after patients enterring SICU. Results： After one week, albu- protein in observation group were better than that in control group （P 〈 of early enteral nutrition in observation group was 80. 12%, while that in The ICU days and mechanical ventilation time in observation group were also better than that in the control group （ P 〈 0.01 ） could ensure the safety of early enteral nutrition, ventilation time and ICU clays and speed up the Conclusion： The tolerance management measures and improve the nutrition indicators, shorten mechanical recovery in sepsis patients with CBP.