机械通气患者早期肠内外营养支持的比较研究

The comparison of early enteral and parenteral nutritional support in mechanical ventilation patients

目的 探讨机械通气早期肠内营养的优点。方法 30例机械通气患者随机分成早期肠内营养(EN)组和早期完全胃肠外营养 (TPN)组 ,在摄入同等热量、同等氮量的条件下进行比较 ,研究期为 10d。结果 EN组氮平衡、血清蛋白浓度高于TPN组 ,机械通气时间、临床费用低于TPN组 ,组间差异均有显著性。两组感染性和营养性并发症的发生率无明显差异。结论 机械通气患者早期能耐受适量的EN ,EN可维持肠黏膜屏障的完整性 ,更好地提供营养 ,减少细菌和内毒素易位 ,有助缩短机械通气的时间 ,且临床费用较TPN低 ,值得推广。

Objective To explore the effect of early enteral nutrition support in the mechanical ventilation patients.Methods 30 patients of mechanical ventilation were randomly divided into enteral nutrition (EN) group and total parenteral nutrition (TPN) group.All patients received the same energy and the same nitrogen.Results Nitrogen balance and preablumin concertraction in EN group improved.Mechanical ventilation time and cost in EN group were lower than those in TPN group.No significant changes were found in infection rate and nutrition complication.Conclusion The mechanical ventilaion patients is safe in EN support.EN is helpful in maintaining the complete entestinal mucous membrane barrier.It can improve the nutrition,reduce the bacteria and endotoxine translocation,and shorten mechanical ventilation time.