肠内与肠外营养对住院患者营养状况影响的研究

目的:比较肠内营养(EN)与肠外营养(PN)对住院患者营养状况的影响。方法:回顾性调查并比较北京和上海6所综合性医院的胃肠外科、心胸外科、消化内科、呼吸内科、神经内科、神经外科和重症监护病房接受EN或PN的1142例住院患者在营养支持前后体重(BW)、血红蛋白(Hb)和血清白蛋白(sALB)的变化。结果:两组BW、Hb及sALB在营养支持后均显著降低,EN组BW和sALB的下降差值显著低于PN组(BW:-1.58±2.36kgvs-2.09±2.66kg,P<0.002;sALB:-2.10±4.13g/Lvs-3.03±4.04g/L,P<0.001),而Hb的变化没有显著性意义。EN组低体重指数(BMI)和低白蛋白血症的患病率在支持后较PN组显著地降低(低体重指数:11.63%vs17.90%,P<0.01;低白蛋白血症:20.51%vs26.24%,P<0.01)。贫血的患病率在EN或PN后均增高,两组间差异无显著性意义。结论:与PN比较,EN在减少体重丢失和减少血清白蛋白降低方面,以及在改善住院患者营养不良患病率方面疗效基本一致或稍好。

STUDY ON THE EFFECT OF ENTERAL AND PARENTERAL NUTRITION ON NUTRITIONAL STATUS OF INPATIENTS

Objective:To compare the nutritional status of inpatients after enteral nutrition (EN) and parenteral nutrition (PN). Method: A multi-center survey of 1 142 inpatients from the Department of gastrointestinal surgery, thoracic surgery, gastroenterology, respiratory disease, neurology, neurosurgery and the intensive care unit of 6 general hospitals in Beijing and Shanghai was adopted in this study. Body weight (BW), haemoglobin (Hb) and serum albumin (sALB) were compared before and after EN or PN respectively. Results: BW, Hb and sALB all decreased after the nutritional support both in EN and PN groups, but only significantly in BW and sALB (BW: -1.58±2.36 kg/m2 vs -2.09±2.66 kg/m2, P<0.002; sALB: -2.10±4.13 g/L vs -3.03±4.04 g/L, P<0.001). There was no significant difference between Hb changes. The morbidity of low body mass index (BMI) and hypoalbuminemia was significantly less in EN group than that in PN group after nutritional support (low BMI%:11.63% vs 17.90%,P<0.01);hypoalbuminemia%: 20.51% vs 26.24%,P<0.01). The morbidity of anemia was increased after EN or PN without significant difference. Conclusion: The body weight loss and serum albumin decrease, as well as the morbidity ofmalnutrition of inpatients after EN were comparable to or even better than PN.