不同热能PN对老年全身炎症反应综合征的治疗研究

评估应用胃肠外营养支持治疗老年全身炎症反应综合征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１０５ＫＪ．ｋｇ＾－１．ｄ＾－１和１４６ＫＪ．ｋｇ＾－１．ｄ＾－１的热能供应量进行了ＰＮ连续６ｄ；对照分析两组蛋白质、糖、脂代谢及动脉血及的变化；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：二组在改善机在

The efficacy of parenteral nutrition with different energy for systemic inflammatory response syndrome (SIRS) in the aged]

To evaluate the efficacy and safety of parenteral nutrition (PN) with lower or higher energy for treating systemic inflammatory response syndrome (SIRS) in the aged, thirty old SIRS critically ill patients were involved in a randomized control clinical trial. Fifteen cases were treated by PN with lower energy (105 KJ.kg-1.d-1), and another fifteen cases with higher energy (146 KJ.kg-1.d-1) for 6 days. The data about metabolisms of protein, glucose and fat, blood gas analysis, acute physiology and chronic health evaluation (APACHE II) were analysed. The results showed that: 1. The effects of 105 KJ.kg-1.d-1 PN in increasing organism protein and maintaining nitrogen balance were the same as those of 146 KJ.kg-1.d-1 PN. 2. The levels of fast blood sugar and triglyceride maintained unchanged in 105 KJ.kg-1.d-1 PN group, while they increased significantly in 146 KJ.kg-1.d-1 PN group(P < 0.05). 3. PaO2 was raised greatly in 105 KJ.kg-1.d-1 PN group, while not in 146 KJ.kg-1.d-1 PN group. 4. 105 KJ.kg-1.d-1 PN and 146 KJ.kg-1.d-1 PN decreased APACHE II(P < 0.05), but the efficiency of 105 KJ.kg-1.d-1 PN was better than that of 146 KJ.kg-1.d-1 PN (P < 0.05). We conclude that PN with 105 KJ.kg-1.d-1 energy intake is more effective and safer for treating SIRS than that with 146 KJ.kg-1.d-1 in the aged.