自制营养餐在重症监护病房机械通气患者中的应用

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1、解放军护理杂志2010年8月第27卷第8B期NursJChinPLA，August2010，Vo1．27，No．8B·1223·自制营养餐在重症监护病房机械通气患者中的应用董杏芳，邓鹤秋，吕红松，张丹，陈莉，黄丛萍【摘要】目的探讨重症监护病房机械通气患者应用自制营养餐的营养支持效果、经济费用及不良反应。方法将64例机械通气患者随机分为试验组和对照组各32例，试验组采用自制营养餐鼻饲，对照组采用能全力鼻饲，观察1周后两组患者的血红蛋白、白蛋白、转铁蛋白、淋巴细胞总数、上臂脂肪厚度、氮平衡、经济费用及不良反应等指标。结果1周后两组患者各项营

2、养学指标均有明显改善，负氮平衡转为正平衡，但试验组的正平衡、空腹血糖及转铁蛋白低于对照组，差异有统计学意义(均P<0．01)；试验组自制营养餐的费用为(32．04±2．3)元／d，低于对照组的(103．O04_-0．0)元／d，差异有统计学意义(P

3、的发生率相对较低，经济实惠，适合在重症监护病房机械通气患者中使用。【关键词】营养餐；机械通气；鼻饲；营养支持【中图分类号lR472．2；R473．5【文献标志码】A【文章编号】1008—9993(2010)8B-1223—03ApplicationofSelf-preparedNourishingDietinPatientswithMechanicalVentilationinIntensiveCareUnitDONGXing—fang，DENGHe—qiu，LVHong—song，ZHANGDan，CHENLi，HUANGCong—p

4、ing(Depart—mentofCardiovascularRespiratoryMedicine，No．458HospitalofPLA，Guangzhou510602，China)【Abstract】objectiveToexploretheeffectofnutritionalsupport，economiccostsandadversereactionsoftheselfpreparednourishingdietinpatientswithmechanicalventilationinintensivecareunit(IC

5、U)．MethodsAtotalof64patientswithmechanicalventilationwererandomlydividedintotheexperimentgroup(一32)fedwiththeself-preparednourishingdietandthecontrolgroup(一32)fedwithnasalnu—tritionfeeding．Thehemoglobin，variantsofalbumin，transferrin，lymphcells，armfatthickness(TSF)，ni—tro

6、genbalance，expensesanduntowardeffectswereevaluatedafteraweekofthetreatment．ResultsAfteroneweek，allthenutritionindicatorsofthetwogroupsweresignificantlyimprovedwithaconversionfromnegativenitrogenbalancetopositivenitrogenbalance．Thelevelsofpositivenitrogenbalance，fastingpl

7、as—maglucoseandtransferrinoftheexperimentgroupweresignificantlylowerthanthoseofthecontrolgroup(P<0．01)．TheexpenseE(32．04±2．3)Yuan／d]oftheself—preparednutritionfoodwassignificantlylowerthanthat[-(103．00±O．O)Yuan／d]ofthecontrolgroup(P~0．01)．Theincidencesofnauseaandvomiting

8、，diarrheaandhighbloodsugar，stressulcerandotheradverseeventsweresignificantlylowerintheexperi—mentgroupt