早期肠道内营养在严重胸部外伤治疗中的作用

The effects of early enteral nutrition on the treatment of Patients with severe thoracic injury

目的 研究早期肠道内营养（EN）在严重胸部外伤患者治疗过程中的作用。方法 对30例严重胸部外伤患者行早期肠道内营养,取同期的30例严重胸部外伤患者行早期肠道外营养（PN）,并动态观察其白蛋白、淋巴细胞数（LC）、体重、谷丙转氨酶（ALT）、血糖、应激性溃疡发病率等变化。结果 伤后10天,EN组与PN组的白蛋白、LC、体重无显著差异（P>0.05）,但伤后10天,EN组ALT低于PN组,分别为（35±4.7）u/L,（38±4.3）u/L,（P<0.05）;EN组血糖也低于PN组,分别为（8.3±3.3）mmol/L,（10.4±3.5）mmol/L,（P<0.05）;EN组应激性溃疡发病率低于PN组,分别为6.67％和26.67％（P<0.05）。结论 早期肠道内营养与肠道外营养具有同样的营养价值,但在保护肝脏、降低血糖、降低应激性溃疡等方面明显优于肠道外营养。

Objective To investigate the effects of early enteral nutrition in the severe thoracic injured patients. Methods The 60 patients were randomly divided into two groups: 30 patients with enteral nutrition (EN),the others with parenteral nutrition (PN).In both groups,the serum albumin and glucose levels,lymphocyte count,body's weight,ALT and the rate of stress ulcer were observed 1,6 and 10 days after thoracic injury. Results The serum albumin levels,lymphocyte count and body's weight showed no significant difference in both groups within 10 days after thoracic injury, but in EN gu-oup, the ALT(35±4.7)u/L, the serum glucose(8.3±3.3mmol/l) and the rate of stress ulcer (6.67%) were all signifitively lower than that of the PN group (38±4.3u/L,10.4±3.5mmol/L,26.67%). Conclusion There was no difference in nutritional e-valuation between the EN and PN group, but the early enteral nutrition is superior in lowing the level of serum glucos and the rate of stress ulcer to the parenteral nutrition.