| 控制血糖结合早期肠内营养治疗多发伤的临床观察 |
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| 引用本文： | 龚华景,覃炳军,叶婷.控制血糖结合早期肠内营养治疗多发伤的临床观察[J].湛江医学院学报,2010,28(3):244-245,247. |
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| 作者姓名： | 龚华景 覃炳军 叶婷 |
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| 作者单位： | 广东省东莞市人民医院内科,广东东莞523000 |
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| 摘 要： | 目的观察控制血糖结合早期肠内营养（EN）治疗多发伤的疗效。方法 46例急性严重多发伤患者随机分为2组,分别给予EN（对照组）、强化胰岛素联合EN治疗（治疗组）。测定入院时及入院后第1、3、7天的血糖、胰岛素、C反应蛋白（CRP）水平,并比较两组的急性生理和慢性健康评分（APACHE）及ICU住院时间、感染及死亡人数。结果与对照组相比,治疗组患者入院后的血糖、胰岛素、CRP水平均明显降低,APACHE评分降低,ICU住院时间明显缩短,差异均有统计学意义（P〈0.01）。治疗组发生严重感染、死亡者分别为5、3例,对照组则为9、7例。结论急性多发伤患者严格控制血糖结合早期EN可减轻应激反应程度、缩短病程、减少住院时间、改善预后。
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| 关 键 词： | 多发伤 血糖 肠内营养 |
Clinical observation on multiple trauma treated by blood glucose control and early enteral nutrition |
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| Institution: | GONG Hua-jing, QIN Bing-jun, YE Tin(Department of Internal Medicine, Dongguan People＇ s Hospital, Dongguan 523000,China) |
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| Abstract: | Objective To observe the clinical efficacy of blood glucose control and early enteral nutrition （EN） in multiple injury.Methods Forty-six patients with acute multiple injury were randomly divided into 2 groups, receiving EN （control group） or intensive insulin and EN therapy （treatment group）. Levels of blood glucose, insulin and C reaction protein （CRP） were detected on admission and day 1, 3 and 7 after hospitalization. Acute physiology and chronic health evaluation （APACHE） II score, length of stay in ICU, infection and death were compared in both groups.Results The levels of blood glucose, insulin and CRP after admission, APACHE Ⅱscore, and length of stay in ICU were significantly lower in treatment group than those in control group （P0.01）. There were 5 severe infections and 3 deaths in treatment group, and 9 severe infections and 7 deaths in control group.Conclusion Strict control of blood glucose and early EN can relieve stress reaction, shorten course of disease, decrease length of stay, and improve prognosis in patients with acute multiple injury. |
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| Keywords: | multiple trauma blood glucose enteral nutrition |
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