添加谷氨酰胺的肠外营养支持在ICU重症颅脑损伤患者术后恢复中的临床效果

Clinical effect of glutamine supplemented parenteral alimentation support on postoperative recovery severe craniocerebral injury in ICU

目的探讨ICU重症颅脑损伤患者应用添加谷氨酰胺的肠外营养的临床效果。方法选取ICU重症颅脑损伤患者120例为研究对象。按照随机数字表法将120例患者分为实验组和对照组,每组患者60例。实验组患者予以添加谷氨酰胺的肠外营养支持,对照组则予以常规肠外营养支持。观察2组患者体内的血清总蛋白（TP）、白蛋白（ALB）水平,并发症发生情况及营养不良炎症评分（malnutrition-inflammation score,MIS）评分。结果实验组患者经治疗后血清TP、ALB水平均显著高于对照组（P〈0.001）。实验组患者并发症发生率为15.0%,明显低于对照组并发症发生率55.0%（χ^2=21.099,P〈0.001）。实验组患者经治疗后MIS评分正常患者明显高于对照组（70.0%vs.33.3%,χ^2=16.151,P〈0.001）。结论添加谷氨酰胺的肠外营养支持治疗法治疗重型颅脑损伤患者可以有效改善其机体术后营养状况,加强营养支持,治疗效果好,对患者病情恢复效果显著。

Objective To investigate the clinical effect of glutamine on parenteral alimentation in patients with severe craniocerebral injury in ICU.Methods 120 patients with severe brain injury in our hospital from November 2013 to November 2014 were selected as the research object. According to the random number table method,the 120 patients were divided into experimental group and control group,60 cases in each group. The patients in the experimental group received glutamine parenteral nutrition support,while the control group received conventional parenteral nutritional support. The serum total protein,albumin,the complications and malnutrition-inflammation score（MIS） scores of the two groups were compared. Results The serum total protein and serum albumin levels of the experimental group post-treatment were significant higher than those in the control group（P〈0. 001）. The complication rate in the experimental group was 15. 0%,significantly lower than the control group of 55. 0%（χ^2= 21. 099,P〈0. 001）. The patients of normal MIS score in the experimental group were obviously superior to the control group（70. 0% vs. 33. 3%,χ^2= 16. 151,P〈0. 001）.Conclusion Adding glutamine to parenteral nutrition support therapy in the treatment of patients with severe craniocerebral injury can effectively improve the nutritional status after operation and strengthen nutrition support.