强化肠内营养对急诊重症患者血糖控制及病情转归的影响

The Effect of Intensified Enteral Nutrition on Blood Sugar Control and Condition of Critically Ill Patients in Emergency Department

目的:考察强化肠内营养对急诊重症患者血糖、营养状态以及并发症的影响。方法:以300例2018年4月-2020年3月就入住我院ICU的患者为研究对象,分为对照组和研究组,每组150例。对照组患者进行肠外营养支持,研究组患者予以肠内营养治疗,通过考察患者血糖、24 h胰岛素使用量、血清总蛋白(Total protein,Tp)、白蛋白(albumin,Alb)、肌酐(creatinine,Scr)以及并发症等指标,评价其对病情的影响。结果:研究组24 h内平均血糖为89.8±38.4 mg/dl,显著低于对照组的157.6±68.3 mg/dl(P<0.05),研究组24 h内胰岛素使用量为18.6±12.3μ,显著低于对照组的34.7±30.6μ(P<0.05)。治疗前,两组患者Tp、Alb和肌酐清除率(creatinine clearance,CCR)水平均无显著差异(P>0.05),治疗后,两组Tp和Alb水平显著升高,CCR水平显著降低(P<0.05);与对照组相比,研究组患者Tp和Alb水平显著升高,CCR水平显著降低(P<0.05)。两组均存在不同程度的腹泻、腹胀以及上消化道出血情况,其中对照组的总发生率为23.33%,研究组的为26.67%,经比较,无显著差异(P>0.05)。结论:强化肠内营养能有效改善急诊重症患者的血糖水平,改善患者的营养状态,安全性高。

Objective:To investigate the effect of intensive enteral nutrition on blood sugar,nutritional status and complications of critically ill emergency patients.Methods:Taking 300 patients who were admitted to the ICU of our hospital from April 2018 to March 2020 as the research objects,they were divided into a control group and a study group,each with 150 cases.Patients in the control group received parenteral nutrition support,and patients in the study group received enteral nutrition therapy.The effects of blood glucose,24 h insulin usage,total serum protein(Tp),albumin(Alb),creatinine(Scr)and complications,etc.,were used to evaluate the impact on the disease.Results:The average blood glucose of the study group within 24 hours was 89.8±38.4 mg/dl,which was significantly lower than the control gro up's 157.6±68.3 mg/dl(P<0.05),and the insulin usage in the study group within 24 hours was 18.6±12.3μ,which was significantly lower than the control group 34.7±30.6μ(P<0.05).Before treatment,there was no significant difference in the levels of Tp,Alb and CCR between the two groups of patients(P>0.05).After treatment,the levels of Tp and Alb in the two groups increased significantly,while the CCR levels decreased significantly(P<0.05).Compared with the control group,the levels of Tp and Alb in the study group were significantly increased,and the level of CCR was significantly decreased(P<0.05).There were different degrees of diarrhea,abdominal distension and upper gastrointestinal bleeding in the two groups.The total incidence of the control group was 23.33%,and that of the study group was 26.67%.After comparison,there was no significant difference(P>0.05).Conclusion:Intensified enteral nutrition can effectively improve the blood sugar level of critically ill patients in emergency departments,and improve the nutritional status of patients with high safety.