肠内营养支持对危重病人营养状态及内毒素水平影响

目的探讨肠内营养（EN）支持对危重病人营养状态及内毒素水平影响。方法选择64例不能经口进食的危重病人，分为完全肠外营养（TPN）组及TPN＋EN组，TPN组采用完全静脉营养支持，TPN＋EN组在病人营养支持全程或部分时间采用EN营养支持，比较两组病人营养支持前后营养状态、血清内毒素及炎性递质的水平。结果治疗1周后，TPN＋EN组病人血清前血清清蛋白、前清蛋白水平高于TPN组（t=2．92、3．58，P〈0．05），血清内毒素、白介素6及肿瘤坏死因子a水平低于TPN组（t=3．54～7．36，P〈0．05）。结论EN支持能够改善危重病人的营养状态，减少病人体内细菌内毒素的生成及炎性损伤。

EFFECT OF ENTERAL NUTRITION ON NUTRITIONAL STATUS AND LEVEL OF ENDOTOXIN IN SERIOUSLY ILL PATIENTS

Objective To investigate the effect of enteral nutrition （EN） on nutritional status and endotoxin level in seriously ill patients. Methods Sixty-four seriously ill patients who could not take food by mouth were selected in this study. The patients were divided into parenteral nutrition （TPN） group and parenteral nutrition combined enteral nutrition （TPN ＋ EN） group. The patients in TPN group were offered total parenteral nutrition; to those in TPN＋EN group, EN was given in the whole course or part of the time. The nutritional status, serum endotoxin and inflammatory factor, before and after the treatment, were compared between the two groups. Results After one week of therapy, the levels of serum albumin and prealbumin in TPN＋ EN group were higher than that in TPN group （t=2.92,3.58;P（0.05）, and serum endotoxin, IL-6 and TNF-a were lower （t=3.54-7.36,P〈0.05）. Conclusion Enteral nutrition support can improve the nutritional status of seriously ill patients, de crease the production of endotoxin and inflammatory damage.