摘要
目的探讨营养支持治疗对重症职业性三氯乙烯药疹样皮炎(OMDT)患者的临床意义。方法将56例OMDT患者随机分为综合营养组和普通膳食组,前者给予肠外营养联合肠内营养措施,后者给予肠外营养联合普通膳食(增加高蛋白质)措施。观察2组治疗前后各项指标。结果治疗1个月后,2组谷氨酸氨基转移酶、血尿素氮、血糖、血浆C-反应蛋白水平均较治疗前下降(P<0.001),血红蛋白、血浆总蛋白、血浆白蛋白、胆固醇、血钾均升高(P<0.001);综合营养组治疗后上述各项指标改善程度较普通膳食组明显(P<0.05或P<0.001)。综合治疗组治疗前后肢体肿胀、水疱渗出、大便潜血、合并感染的发生率较治疗前下降(P<0.05或P<0.01);普通膳食组治疗后除肢体肿胀发生率下降外(P<0.05),其余3个指标发生率治疗前后差异无统计学意义(P>0.05)。综合治疗组平均住院时间(85.1±22.6)d低于普通膳食组(97.6±22.0)d,差异有统计学意义(P<0.05)。结论及时合理的营养支持对促进OMDT患者皮肤、黏膜损伤创面的愈合和肝功能恢复有明显的支持作用,有利于减少并发症,缩短住院时间,改善预后。
Objective To investigate and analyze the clinical significance of nutrition support therapy in patients with severe occupational medicamentosa-like dermatitis due to trichloroethylene（OMDT）.Methods Fifty-six patients of severe OMDT were randomly divided into comprehensive nutrition support group（experimental group） and normal diet group（control group）.The experimental group received enteral nutrition combined with parenteral nutrition while the control group received normal meal combined with parenteral nutrition.The related indicators were observed before and after the treatment.Results After the treatment,the indexes of glutamate amino transaminase,blood urea nitrogen,blood glucose and serum C-reactive protein in 2 groups were decreased than before（P ＆lt; 0.001）,while the indexes of plasma total protein,albumin,hemoglobin,cholesterol,potassium were higher than before（P ＆lt; 0.001）.The improving degree of the above indexes of the experimental group were significant,compared with those of the control group（P ＆lt; 0.05 or P ＆lt; 0.001）.The incidences of limb swelling,blisters and oozy,stool occult blood and complicated infection of the experimental group were lower than before（P ＆lt; 0.05 or P ＆lt; 0.01）.The incidences of limb swelling of the control group were lower than before（P ＆lt; 0.05）,but no statistical significances were shown in the incidences of blisters and oozy,stool occult blood and complicated infection（P ＆gt; 0.05）.Moreover,in 2 groups,skin strip and weight index were improved after the treatment.The average stay in hospital of the experimental group was significantly less than that of the control group [（85.1 ± 22.6） vs.（97.6 ± 22.0] days,P ＆lt; 0.05].Conclusion Timely and reasonable nutrition supports could significantly reduce the complications and shorten hospital stays for the treatment of OMDT.
出处
《中国职业医学》
CAS
北大核心
2013年第3期200-203,共4页
China Occupational Medicine
基金
国家临床重点专科建设项目经费资助项目(2011-09)
广东省职业病防治重点实验室(2012A061400007)
广东省医学科学技术研究基金(A2009053)
关键词
三氯乙烯
药疹样皮炎
营养支持
肠内营养
肠外营养
治疗
Trichloroethylene
Medicamentosa-like dermatitis
Nutritional Support
Parenteral nutrition
Enternal nutrition
Treatment
