摘要
目的拟观察比较完全肠外营养(total parenteral nutrition,TPN)、完全肠内营养(enteral nutrition,EN)、经口饮食(oral diet,OD)这三种营养支持方法的优、缺点以期为患者提供最佳、最适当的营养支持方案。方法收集2005—2007年各随机组共47例患者在层流病房中的0^+15 d的24 h尿,测定尿素氮;测定0^+15 d每日食物、呕吐物中的含氮量,记录每日输液中的含氮量,计算氮平衡;详细记录各组患者呕吐、恶心、腹泻、口腔炎的发生率;分别于移植后的0、7、14 d测量患者的体质量、肱三头肌皮褶厚度、上臂围、计算上臂肌围、测定患者的血清等指标,并记录。结果氮平衡:47例患者在0^+15 d内均为负氮平衡。蛋白质摄入量,EN组、OD组明显高于TPN组(P<0.05)。滞留层流病房的时间、口腔炎的发生三组之间没有显著差异(P>0.05)。呕吐和腹泻发生率EN组和OD组均显著高于TPN组(P<0.05)。EN组和OD组之间没有显著差异。试验开始之初,三组患者的各项指标相比均没有显著差异(P>0.05)。7 d,EN、OD组的血清Hb、PreAlb高于TPN组(P<0.05),OD组的Cr高于EN组和TPN组(P<0.05);其余指标均没有显著差异(P>0.05)。14 d,EN组、OD组的Bun、Cr值显著高于TPN组(P<0.05),OD组的TSF值、血清TP值显著高于TPN组(P<0.05)。其余指标三组之间均没有显著差异(P>0.05)。结论OD组的营养支持方案优于EN组和TPN组,EN组优于TPN组。
Objective To compare three nutrition support schemes including total parenteral nutrition,enteral nutrition and oral diet for hematopoietic stem cell transplantation （HBSCT） recipients to find a most suitable way of nutritional supplements for these patients. Methods Forty-seven HBSCT recipients from 2005 to 2007 were randomly divided into TPN group, EN group and OD group. Urines in 24 h of each recipient in laminar flow ward during the first day to 15 day were collected to determine the blood urea nitrogen. The nitrogen balances were calculated by determining the nitrogen quantity in their diets and vomitus and recording the nitrogen quantity in their transfusion. The incidence of vomit, nausea, diarrhea and stomatitis in patients were recorded. Body weight, triceps skin-fold, arm circumference were measured, arm muscle circumference were calculated and hemoglobin, total protein, Glu, albumin, pre-albumin, Bun, creatine and uric acid in blood serum were detected on 0^th, 7^th and 14^th days. Results Nitrogen balance was negative in all 47 recipients during 0 - ＋ 15 day. The protein intakes of patients in EN group and OD group were higher than in TPN group. There were no significant differences in stomatitis appearance among three groups on their stay in laminar flow hospital room. Patients in EN group and OD group had higher incidences of vomit and diarrhea than in TPN group （ P 〈 0.05 ） while no difference between patients in EN group and in OD group. All the data had no differences before experiment in three groups. After 7 days, Fib and PreAlb in EN and OD group had a significant increase than in TPN group （ P 〈 0.05 ）, and Cr in EN group had a significant increase than in other two groups（ P 〈 0.05 ） while other indexes had no differences（ P 〉 0.05 ）. Bun and Cr in EN and OD group had significant increases than in TPN group after 14 days later（ P 〈 0.05 ）, and TSF and TP in OD group had significant higher value than in TPN group （ P 〈 0.05 ）. Conclusion The OD scheme
出处
《同济大学学报（医学版）》
CAS
2008年第3期42-46,共5页
Journal of Tongji University(Medical Science)
基金
上海市卫生局科研基金资助项目(0540102)
