腹部创伤围手术期的营养支持中GIK液的应用

The Application of GIK Fluid for Perioperative Nutritional Support of Abdominal Injury

目的 观察不同营养支持对腹部创伤病人的治疗效果。方法 腹部创伤病人 2 0例为治疗组 ,采用全静脉营养加用GIK液治疗 ,14例作为对照组 ,不用GIK液治疗 ,其余治疗与治疗组相同 ,观察两组的疗效。结果 治疗组临床主观症状改善90 %较对照组明显 ( 5 2 % ) ,有差异 (P <0 .0 5 ) ;术后上臂周经和三头肌皮皱厚度治疗组分别平均减少 5～ 10mm和 5～ 7mm ,对照组平均减少 2 1～ 2 4mm和 2 2～ 2 5mm ,两组间有差异 (P <0 .0 5 ) ;血浆前蛋白水平治疗组较对照组高 ,统计学有差异P <0 .0 5 ,而血浆白蛋白水平、外周血淋巴细胞计数及平均住院日两组间均无差异P >0 .0 5 ;对照组发生感染裂开 2例 ,治疗组无感染。结论腹部创伤病人应用GIK营养支持可使精神及体力恢复加快 ,明显减少肌体蛋白消耗 ,降低创伤的应激反应。

Objectives To observe the effect of different nutritional support in patient with abdominal injury. Methods 20 patients with abdominal injury in the treatment group were giving GIK fluid in addition to total intravenous nutrition. And 14 patients in control group were treated with total intravenous nutrition, without GIK fluid, but the other treatment is same to treatment group. Results The difference of amelioration of patients' symptom between treatment group (90%) and control group (52%) were significant (P< 0.05 ). After operation, the girth of upper brachium and the depth of rhicnosis of the triceps are reduced 5～10mm and 5～7mm on average in treatment group, but they are 21～24mm and 22～25mm in the control group. The difference of them in two groups is significant. The level of plasma prealbumin in treatment group is higher than in control group (P<0.05). But the differences of the level of plasma albumin, Lymphocyte count in peripheral blood, average hospitalization days are no significant between the two groups (P>0.05). In the control group, wound dehiscence in two cases were caused by infection, but in the treatment group, no wound infection. Conclusion The application of GIK fluid for nutritional support in abdominal injury can make the patients recover more quickly in mentality and body. It can reduce the consumption of protein, and reduce the stress reaction of the wound .