慢性重症肝炎患者营养支持及疗效评价

目的: 评价慢性重症肝炎患者营养状况、营养支持及疗效。方法: 143例慢性重症肝炎患者,入院后进行SGA评估,明确营养状况。分三组,肝病综合治疗和肠内营养+肠外营养;综合治疗+肠外营养;综合治疗+肠内营养。监测0~6 w肝功能及营养指标变化,最后评价临床疗效。结果: 90%以上患者存在中重度营养不良。综合治疗+肠内和肠外营养方案改善肝功能(ALT、Tbil)及营养指标(TP、TC)效果最好,显效率明显高于另两组(P<0.05)。肠内营养略好于肠外营养方案。结论: 慢性重症肝炎患者多数存在营养不良。综合治疗的同时肠内+肠外营养支持疗效最好,应鼓励患者适量进食。

NUTRITIONAL SUPPORTS AND EVALUATION OF THEIR THERAPEUTIC EFFECTS ON SERIOUS CHRONIC HEPATITIS

Objective:To assess the nutritional status of patients with chronic serious hepatitis B, and the therapeutic effect of nutritional support on this kind of patients. Methods:143 patients received nutritional assessment by means of SGA immediately after admitted into hospital and were divided into three groups, A, B and C. Patients in group A were given both enteral and parenteral nutrition besides other therapeutics with medicines. Group B was given only parenteral nutrition, while group C was given only enteral nutrition. The liver function and nutritional status were monitered during the treatment period of 6 weeks. Results:More than 90% of patients suffered malnutrition from middle to severe degree. Nutritional support method in group A showed better effect on liver function(ALT, Tbil) and nutritional status(TP, TC) than those in group B and C. The excellent recovery rate in group A was higher than that in group B and C (P<0.05). Conclusion:Most of the patients with chronic serious hepatitis have malnutrition. Enteral nutrition combined with parenteral nutrition showed the best effect on these patients, so that we should encourage patients to take more food if possible.