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目的 :评估应用胃肠外营养支持 (PN)治疗老年全身炎症反应综合征 (SIRS)危重患者时不同热能摄入的有效性和安全性。方法 :30例老年SIRS危重患者随机分为低热能组和高热能组各 15例 ,分别按 10 5KJ·kg- 1 ·d- 1 和 146KJ·kg- 1 ·d- 1的热能供应量进行PN连续 6d;对照分析两组蛋白质、糖、脂代谢及动脉血气的变化 ;并以急性生理和慢性健康评分系统(APACHEⅡ)评估病情严重程度的变化。结果 :二组在改善机体蛋白及氮平衡方面效果相同 ;低热能组的空腹血糖、甘油三酯水平不变 ,而高热能组显著升高 (P <0 .0 5 ) ;低热能组纠正PaO2 和降低APACHEⅡ评分均优于高热能组 (P <0 .0 5 )。结论 :应用PN治疗病情危重的老年SIRS时以 10 5KJ·kg- 1 ·d- 1 供应热能较为有效和安全
PURPOSE: To evaluate the efficacy and safety of different parenteral calories when parenteral nutrition support (PN) is used in the treatment of critically ill elderly patients with systemic inflammatory response syndrome (SIRS). Methods: Thirty patients with severe SIRS were randomly divided into 15 groups according to their thermal energy supply of 105 KJ · kg-1 · d-1 and 146 KJ · kg-1 · d-1, respectively. 6th consecutive day. The changes of protein, glucose, lipid metabolism and arterial blood gas were compared between the two groups. APACHEⅡ was used to evaluate the severity of the disease. Results: The two groups had the same effect on improving body protein and nitrogen balance. The fasting blood glucose and triglyceride levels were unchanged in low-heat group, while those in high-heat group were significantly higher (P <0.05) And reduce APACHE Ⅱ score were higher than the high thermal energy group (P <0.05). Conclusion: It is more effective and safe to supply heat at 105 KJ · kg-1 · d-1 when PN is used to treat elderly patients with SIRS