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目的:探讨免疫肠内营养(IEN)联合生长激素(GH)在呼吸机依赖合并营养不良危重症病人中的应用效果。方法:采用前瞻、随机、对照的方法分为三组,即A组给予标准营养支持治疗;B组给予GH治疗;C组给予IEN制剂(瑞能)联合GH治疗。三组病人均于治疗前和治疗后第14天分别测定血清总蛋白(TP)、清蛋白(ALB)、血糖峰值,外周血淋巴细胞总数(TLC),并统计胰岛素日用量、机械通气时间和ICU入住时间等。结果:与A组比较,C组病人的血清TP、ALB和TLC的水平明显升高(P<0.05),血糖峰值未见明显变化(P>0.05);与B组比较,C组胰岛素日用量明显减少,TLC和ALB明显升高(P<0.05)。C组的机械通气时间和ICU入住时间均明显短于A组和B组(P<0.05)。结论:IEN联合应用GH能促进营养不良导致呼吸机依赖病人的蛋白质合成,改善营养状况,提高免疫功能,促进脱机,改善预后。
Objective: To investigate the effect of enteral nutrition (IEN) combined with growth hormone (GH) in patients with critically ill ventilator-dependent malnutrition. Methods: A prospective, randomized, controlled trial was divided into three groups: Group A received standard nutritional support treatment; Group B received GH treatment; Group C received IEN (Renengine) plus GH treatment. Serum total protein (TP), albumin (ALB), peak blood glucose and total peripheral blood lymphocyte count (TLC) were measured before treatment and on the 14th day after treatment in all three groups. The daily insulin dosage, the duration of mechanical ventilation and ICU check-in time. Results: Compared with group A, the levels of serum TP, ALB and TLC in group C were significantly increased (P <0.05), and the peak of blood glucose did not change significantly (P> 0.05). Compared with group B, Significantly reduced, TLC and ALB were significantly increased (P <0.05). The duration of mechanical ventilation and ICU stay in group C were significantly shorter than those in groups A and B (P <0.05). CONCLUSIONS: IEN combined with GH can promote malnutrition and lead to the reliance on patients’ protein synthesis, improve the nutritional status, improve the immune function, promote the off-line and improve the prognosis.