目的:探讨合理的营养支持方式对重症急性胰腺炎(SAP)患者营养状况及预后的影响。方法:将60例SAP患者随机分为全胃肠外营养支持(对照组)和肠内与肠外相结合营养支持(实验组)两组,对比营养支持前后两组患者的血红蛋白、总蛋白、血清白蛋白、氮平衡、血脂等生化指标,每天观察相关并发症情况。结果:实验组血清白蛋白、总蛋白、血红蛋白、氮平衡方面明显优于对照组(Plt;0.05),且并发症少。结论:肠内与肠外结合的营养支持方式可以改善SAP患者的营养状况,对SAP患者治疗有积极的作用。
Experienc of nurtitional treatment to 7 patients with acute renal failure (ARF) and nitrogemia after biliarty (tract) surgery is reported in this article. Nittrogen source inn all cases was obtained from "Renal Amine" and "7% Vamin" etc,which are composed of 8 essential amino acids (EAA), and the nergery sources are mainly supplyed by Intralipid (20 or 10%) and suitable amount of glucose. The nutritional admicture of "all in one" were employed as parenteral nutrition (PN). Satisfactary curative effecs in these patients were obtained. The suthors consider that (a) the nutritional treatment of different casuses of ARF should be providing enough energy and more EAA requirments than in normal need to synthesizw non-essential amino acide (NEAA) and protein from excessive blood urea nitrogen (BUN) for redcuing pritein breakdown and nitrogemia, and (b) 20% Intralipid is an effective low-volume, highly calories nutritional agent specially in ARF patients with restiction of waterr.
Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
ObjectiveTo evaluate the value of omega-3 fish oil fat emulsion in parenteral nutrition support after radical resection of gastric cancer patients.MethodsThe clinical data of 80 patients in Tongling Peopl’s Hospital undergoing radical resection of gastric cancer from March 2018 to September 2019 were enrolled by retrospective method. Of them, 40 patients were treated with routine parenteral nutrition (control group) and 40 patients were treated with extra 100 mL omega-3 fish oil fat emulsion after operation (observation group). Nutritional and stress indicators included blood total albumin (TP), albumin (ALB), c-reactive protein (CRP), and procalcitonin (PCT) on one day before operation, and 1st, 3rd, and 7th day after operation were collected. The collected indexes of liver function included blood cholesterol (CHO), triglyceride (TG), total bilirubin (TBIL), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (γ-GT) on one day before operation, and 3rd and 7th days after operation.Results① Nutritional indicator. There was no significant differences in TP and ALB levels between the two groups on one day before operation, and on the 1st, 3rd, and 7th day after operation (P>0.05). In the same group compared with one day before operation, the average TP level of the control group and the observation group decreased on the 1st, 3rd, and 7th day after operation (P<0.05), and in the control group and the observation group, the ALB level decreased on the 1st day after operation (P<0.05), and increased on the 7th day after operation (P<0.05). ② Stress index. There was no significant difference in CRP and PCT levels between the two groups on one day before and one day after operation (P>0.05), and the CRP and PCT levels in the observation group were lower than those in the control group on the 3rd day and 7th day after operation (P<0.05). Compared with the CRP and PCT levels on the one day before operation, the average CRP and PCT levels in the observation group and the control group increased on the 1st, 3rd, and 7th day after operation (P<0.05). ③ Liver function index. There was no significant differences in CHO, TG, and γ-GT levels between the two groups on one day before operation and the 3rd day after operation (P>0.05), but the above indexes of observation group were lower on the 7th day after operation than those of the control group (P<0.05). There was no significant differences on TBIL, ALT, and ALP levels between the postoperative observation group and the control group (P>0.05). Compared with one day before operation in the same group, there was no significant difference on CHO and ALP levels on 3rd and 7th day after operation in both the observation group and control group (P>0.05). There was no significant differences in TG and TBIL levels in the observation group on 3rd and 7th day after operation (P>0.05), but the TG and TBIL levels in the control group were increased on 7th after operation (P<0.05), and the ALT and γ-GT levels in the observation group and the control group on 7th day after operation were increased in the same group compared with one day before operation (P<0.05).ConclusionParenteral nutrition with omega-3 fish oil fat emulsion do not improve the recent postoperative nutritional status, but reduce the inflammatory stress response and protecte liver function in patients with gastric cancer after operation.
摘要:目的: 探讨早期肠内营养支持在胃肠道恶性肿瘤术后患者中应用的临床效果。 方法 :54 例胃肠道恶性肿瘤行根治手术的患者,随机分为对照组和研究组,分别接受肠外营养支持(PN)和肠内营养支持(EN)。比较两组治疗前后的血清白蛋白、前白蛋白和转铁蛋白水平,肝肾功能指标,胃肠功能恢复时间以及并发症的发生率。 结果 :经过术后7 d 的营养支持治疗,EN组术后血清前白蛋白、转铁蛋白水平升高程度明显大于PN组,胃肠功能较PN组更快恢复。在术后并发症的发生率和肝肾功能指标方面两组没有显著性差异。 结论 :早期肠内营养支持能够安全有效地促进胃肠道肿瘤术后患者的恢复。Abstract: Objective: To investigate the clinical effect of early enteral nutrition (EN) support on postoperative patients with gastrointestinal malignancy. Methods : A total of 54 postoperative patients with gastrointestinal malignancy were randomly divided into EN group and parenteral (PN) group. Both groups received isocaloric and isonitrogen nutrition support. The serum albumin, transferrin, prealbumin and liver and renal function were measured using standard techniques. The gastrointestinal function and postoperative complications were evaluated. Results : After nutrition support, serum albumin was not significantly different between two groups. Compared with PN group, serum transferrin and prealbumin level significantly increased in EN group (P＜005). The gastrointestinal function in EN group resumed earlier than that in PN group. There was also no difference in liver and renal function and postoperative complications between two groups. Conclusion : The application of early enteral nutrition support is beneficial to the recovery of the gastrointestinal cancer patients after surgery.
ObjectiveTo investigate the effects of total parenteral nutrition in neonatal patients and study the nursing methods for these neonates. MethodsWe retrospectively analyzed the clinical data of 70 neonatal patients who accepted total parenteral nutrition in our hospital from October 2010 to October 2011. Physiological indexes were compared before and after total parenteral nutrition. ResultsSignificant improvements in the nutritional status of all children were observed. All patients achieved good efficacy and effective care. ConclusionTotal parenteral nutrition support for critically ill newborns is of great significance, and good caring also plays an important role.
ObjectivesTo systematically review the efficacy and safety of enteral nutrition (EN) for severe acute pancreatitis (SAP) patients within 48 hours after admission.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on early EN (starting within 48 hours after admission) in SAP from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 9 RCTs involving 1 074 patients were included. The results of meta-analysis showed that: compared to patients with EN after 48 hours or parental nutrition, the patients given EN within 48 hours after admission had lower mortality (RR=0.53, 95%CI 0.29 to 0.96, P=0.036) and morbidity of multiple organ dysfunction syndrome (MODS) (RR=0.58, 95%CI 0.44 to 0.77, P<0.001). However, no significant differences were found in systemic inflammatory response syndrome (SIRS) (RR=1.00, 95%CI 0.86 to 1.16, P=1.00).Conclusions The current evidence shows that EN within 48 hours after admission can reduce the mortality and morbidity of MODS in SAP patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.