外科ICU302例患者的肠外营养支持及护理分析

目的 评价TPN在外科重症监护病例支持治疗的价值及其护理要点。方法 回顾性分析302例外科ICU病人接受TPN支持治疗，52例（17．2％）经周围静脉途径输注，250例（82．8％）经中心静脉途经输注，术后TPN平均时间15．4天。比较术前及术后第3、7、14天多项营养监测指标。结果 87例（28．8％）危重病得到控制或好转；208例（68．9％）接受大手术患者术后恢复顺利，除3例手术切口感染和3例周围静脉炎外，无其它并发症发生。7例（2-3％）死于多脏器功能衰竭。在TPN治疗中。血糖、甘油三脂升高（P〈0．05）。结论 TPN治疗对外科ICU病者的顺利康复作用显著，有利于减少并发症，提高治愈率．降低死亡率。老年患者TIN治疗应掌握低糖、低脂和低热量供给，适当增加蛋白质的原则。

Analyzing of total parenteral nutrition and its nursing in 302 postoperatie patients of ICU

Objective To ealuate the alue of total parenteral nutrition(TPN)and conclude the keypoints of nursing.Material and Methods Retrospectiely analyzing 302 cases of postoperatie ICU patients who hae receie TPN.TPN by peripheral eins in 52(17.2%)patients and by central ein in 250(82.8%).The oerage time of TPN was 15.4 days.Compare the nutrition monitoring index of preoperation with that of 3,7,14days after operation.Results 87(28.8%)seere cases were controlled.208(68.9%)cases were recuperated after operation.No other complication was found except 3 cases of infection of incisure and 3 cases of peripheral phlebitis during TPN.7 cases(2.3%)died from multiple organs failure.The glucose and triglycerol in blood were increased during TPN(P<0.05).Conclusion TPN plays an important role in the rehabilitation of ICU patients and helps reducing complication,increasing healing rate and reducing mortality.Low sugar,Iow fat,low energy and enough protein are required of the elder during TPN.