实用医学杂志 ›› 2021, Vol. 37 ›› Issue (2): 238-242.doi: 10.3969/j.issn.1006⁃5725.2021.02.021

• 临床研究 • 上一篇    下一篇

低甲氧基果胶应用于重型颅脑损伤患者的临床观察

臧守华, 张玉坤, 陈军   

  1. 苏州大学附属第一医院麻醉科重症监护病房(江苏苏州 215000)
  • 出版日期:2021-01-25 发布日期:2021-01-25
  • 通讯作者: 张玉坤 E⁃mail:zhangyukun@suda.edu.cn
  • 基金资助:
    江苏省苏州市民生科技计划项目(编号:sys2018038)

Clinical observation on application of enteral feeding with low⁃methoxyl pectin in patients with severe trau⁃ matic brain injury

ZANG Shouhua,ZHANG Yukun,CHEN Jun
  

  1. Department of Surgical Intensive Care Unit of Anesthesiologythe First Hospital Affiliated to Soochow UniversitySuzhou 215000China
  • Online:2021-01-25 Published:2021-01-25
  • Contact: ZHANG Yukun E⁃mail:zhangyukun@suda.edu.cn

摘要:

目的 探索低甲氧基果胶在重型颅脑损伤(sTBI)患者中的应用。方法 选择本院 80 sTBI 患者,随机分为对照组、果胶组,每组 40 例。所有患者在转入ICU 24 ~ 48 h 内开始行肠内营养,果胶组在每日肠内营养基础上添加低甲氧基果胶,连续使用 7 d 以上。收集患者治疗 7 d 内血糖平均值 GLUave)、血糖变异系数(GLUcv)、胰岛素使用情况,记录患者的胃肠道耐受情况、机械通气(MV)时间、 呼吸机相关性肺炎(VAP)发生率以及前白蛋白(PA)等指标,比较两组患者治疗前后上述指标的区别。 结果 治疗后果胶组 7 d GLUave、GLUcv 及胰岛素使用时间明显低于对照组(均 P < 0.05),胰岛素使用 率虽然也低于对照组,但差异无统计学意义(P = 0.16)。两组患者治疗后的 PA 均有所上升,且果胶组明 显高于对照组(均 P < 0.05)。果胶组的胃肠不耐受发生率及 MV 时间也均明显低于对照组(均 P < 0.05), VAP 发生率两组间对比差异无统计学意义(P > 0.05)。结论 低甲氧基果胶有利于 sTBI 患者肠内营养时 血糖的控制,降低胃肠不耐受的发生率,缩短机械通气的时间并改善营养状况。

关键词:

Abstract:

Objective To observe the effects of enteral nutrition(EN)emulsion with low⁃methoxyl pectin in patients with severe traumatic brain injury(sTBI). Methods Eighty severe craniocerebral trauma patients were randomized into pectin or control group(each n = 40). The EN support began within 24~48 hours after the patients were transferred to ICU. In addition,the pectin group received low ⁃methoxyl pectin for 7 days. Average blood glucose(GLUave),blood glucose variation coefficient(GLUcv),amount of insulin used and pre⁃albumin (PA)were observed 7 days after EN support. Gastrointestinal tolerance situations,the duration of mechanical ventilation(MV)and incidence of ventilator associated pneumonia(VAP)were studied. Results Significantly lower levels of GLUave and GLUcv were observed in the pectin group compared with those of the control group(P < 0.05). There were significantly shorter hours of insulin therapy in pectin group than in control group(P < 0.05),but there was no significant difference of numbers of patients treated with insulin between two groups(P = 0.16). The PA of pectin group was significantly higher than that in control group(P < 0.05),and the indexes of gastrointestinal toler⁃ ance were better in pectin group(P < 0.05). The duration of MV in pectin groups were shorter than that of control group(P < 0.05),but there was no significant difference in the incidences of VAP between two groups(P = 0.46). Conclusions Low⁃methoxyl pectin could facilitate blood glucose control and gastrointestinal tolerance in patients with severe traumatic brain injury,and it also could shorten the duration of mechanical ventilation and contribute to the improvement of nutritional status

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