摘要
目的 探讨外科危重病人给予营养支持的效果。方法 对 2 2例外科危重病人实施肠外营养 (PN ) ,早期总热量不超过 2 0Kcal/kg·d ,供氮量不超过 0 .12 g/kg·d ,脂肪供热不超过40 %;应激消退期 ,相应增加供热、氮量 ,总热量不超过 2 5Kcal/kg·d ,供氮量为 0 .2 0 g/kg·d ,以满足机体合成代谢的需要。一旦肠道功能恢复逐渐转为肠内营养。结果 本组治愈 17例 ,死亡 5例 ;治疗过程中未出现明显的糖、脂代谢异常和肝酶谱变化的代谢性并发症。EN期间无严重腹泻、腹胀等并发症。使用呼吸机支持者均一次脱机成功。结论 循序渐进、阶段性的肠外营养支持 ,并适时过渡到EN ,可提高危重病人的抢救成功率 ,降低并发症和死亡率。
Objective To evaluate the effects of nutritional support for surgical critical patieats. Methods Twenty-two surgical critical patients were treated by total parenteral nutrition(PN)or enteral nutrition (EN). Among the 22 patients, 10 cases were suffered from MOD. Nutritional substances and metabolism were investigated. In the early stressing stage, low energy(<20kcal/kg·d) and nitrogen (<0.12g/kg·d) supply were given to the critical patients and lipid calorie supply of PN was less than 40 percent. In the late stage of stessing, high energy(<25kcal/kg·d) and nitrogen(< 0.20 g/kg·d ) were supplied accordingly. EN should be taken when gastrointestinal function was recovered.Results 17 cases were cured, 5 cases dead. During the period of PN, glucose and fat metabolism and liver function were normal,complications such as diarrhea、vomiting and abdominal distention didn't occur.Patients weaned from mechanical ventilation at one time.Conclusions The results suggest that parenteral nutrition should be given progressively and enteral nutritional support is very important for the critical patients.
出处
《临床外科杂志》
2001年第1期20-22,共3页
Journal of Clinical Surgery
关键词
危重病人
肠外营养
肠内营养
Critical patient
Parenteral nutrition
Enteral nutrition
