序贯性肠内营养在危重型手足口病患儿中的应用效果

Application effect of sequential enteral nutrition on children with severe hand,foot and mouth disease

目的观察序贯性肠内营养(SEN)辅助治疗危重型手足口病(HFMD)的临床效果。方法危重型HFMD患儿58例,按随机数字表法分为试验组和对照组,每组29例。两组患儿均给予常规治疗及护理,在此基础上试验组给予SEN,对照组给予鼻饲配方奶,疗程7~14 d。在提供营养液前及第5天、出院时,检测两组Hb、白蛋白(ALB)、前蛋白(PA)、FBG水平,观察喂养不耐受、消化道出血、呼吸机相关性肺炎发生率以及入住ICU时间、住院时间。结果随观察时间延长,两组Hb、ALB、PA水平均逐渐升高(P<0.05),第5天及出院时试验组Hb、ALB、PA水平均高于对照组(P<0.05);试验组各时间点FBG水平稳定,对照组FBG水平波动较大(P<0.05)。试验组的喂养不耐受、消化道出血、呼吸机相关性肺炎发生率均低于对照组(P<0.05),入住ICU时间、住院时间均短低于对照组(P<0.05)。结论 SEN能有效改善危重型HFMD患儿的营养状况,减少并发症发生,缩短住院时间。

Objective To observe the clinical efficacy of sequential enteral nutrition （SEN） in the adjunctive therapy of severe hand ,foot and mouth disease （HFMD）. Methods Fifty-eight children with severe HFMD were divided into experiment group and control group using random number table ,with 29 cases in each group. Besides routine therapy and nursing care performed in both groups, SEN was performed in the experiment group while nasal feeding with formula milk in the control group, and the treatment lasted for 7 - 14 days. Before nutrient supply, on the 5th day of nutrient supply and the day of discharge, the levels of Hb, albumin（ ALB）, prealbumin （PA） and FBG were detected in both groups. The incidence rates of feeding intolerance,digestive tract hemorrhage,ventilator-associated pneumonia, ICU stay and hospital stay were observed. Results The levels of lib, ALB and PA increased gradually with the increasing observation time （ P 〈 0.05 ）. On the 5th day of nutrient supply and the day of discharge,the levels of Hb, ALB and PA in the experiment group were higher than those in the control group（ P 〈 0.05 ）. The FBG level at each time point kept stable in the experiment group, but fluctuated significantly in the control group （P 〈 0.05 ）. The incidence rates of feeding intolerance, digestive tract hemorrhage, ventilator-associated pneumonia in the experiment group were lower than the rates in the control group（ P 〈 0.05 ）. ICU stay and hospital stay in the experiment group were less than those in the control group（ P 〈 0.05 ）. Conclusion SEN can effectively improve the nutritional state of the children with severe HFMD, reduce the incidence of complications and shorten hospital stay.