安素对高龄鼻饲患者营养指标的影响

Effects of Ensure Nutrison on nutrition indicators of elderly patients with nasal feeding

摘要:

目的：探讨肠内营养（Enteral nutrition，EN）剂安素对高龄鼻饲饮食患者营养指标的影响。方法：从2011年2月至12月，选取符合要求患者41例，先行自制EN（Self-made enteral nutrition，SMEN）液鼻饲30 d，然后用安素鼻饲30 d，保证热量达到104.6 kJ[25 kcal/（kg·d）]。于SMEN鼻饲前、SMEN鼻饲后15、30 d，安素鼻饲后15、30 d检测患者血红蛋白（Hemoglobin，HBG）、淋巴细胞总数（Total lymphocyte count，TLC）、血清总蛋白（Serum total protein，TP）、血清白蛋白（Serum albumin，ALB）、前白蛋白（Pre-albumin，PA）、血清肌酐（Serum creatinine，Cr）、血尿素氮（Blood urea nitrogen，BUN），计算氮平衡（Nitrogen balance，NB）；测量患者腰围、臀围、上臂中围（Mid-arm circumference，MAC）和肱三头肌皮褶厚度（Triceps skin-fold thickness，TSF），计算上臂肌围（Mid-arm muscle circumference，MAMC）。结果：SMEN鼻饲后30 d，患者的TLC、ALB、PA较前降低（P<0.05），其余各指标变化无统计学差异。安素鼻饲后15 d，患者的PA、ALB、HBG、Cr与使用安素前比较明显增加（P<0.05）。安素鼻饲后30 d与安素鼻饲前比较，患者的HGB、ALB、TP、PA、TLC、Cr、NB、腰围和臀围等营养指标明显增高。女性患者MAC、TSF有所增加，但男性患者并无明显增加。安素使用前后胃肠道反应和电解质紊乱发生率无明显增加，血糖控制基本达标。结论：EN粉剂安素能改善高龄经鼻饲EN患者的营养指标，并不增加胃肠道反应和电解质紊乱的发生率。

Abstract:

Objective：To investigate the effects of enteral nutrition（EN） agent of Ensure Nutrison on nutrition indicators for elderly patients with nasal feeding. Methods：Totally 41 hospitalized elderly patients in department of geriatrics in the First Affiliated Hospi－tal of Chongqing Medical University from February 2011 to December 2011 were enrolled. The self-made enteral nutrition（SMEN） was applied for 30 d through nasogastric tube and Ensure Nutrison was applied for 30 d to ensure the targeted caloric of 104.6 kJ[25 kcal/（kg·d）] .Hemoglobin（HGB），total lymphocyte count（TLC），serum total protein（TP），serum albumin（ALB），pre-albumin（PA），serum creatinine（Cr），blood urea nitrogen（BUN） and calculated nitrogen balance（NB） were detected；the waist and hip circumfer－ences and mid-arm circumference（MAC），triceps skin-fold thickness（TSF） were measured and mid-arm muscle circumference（MAMC） was calculated before SMEN nasal feeding，at 15 d，30 d after SMEN nasal feeding and at 15 d，30 d after Ensure Nutrison nasal feeding. Results：At 30 d after SMEN nasal feeding，the levels of TLC，ALB and PA were significantly lowered compared with those before SMEN nasal feeding（P<0.05），but there was no significant difference among other nutrition indicators. At 15 d after En－sure Nutrison nasal feeding，the levels of PA，ALB，HBG and Cr were significantly higher compared with those before Ensure Nutrison nasal feeding（P<0.05）. At 30 d after Ensure Nutrison nasal feeding，the levels of HGB，ALB，TP，PA，TLC，Cr，NB，waist and hip cir－cumferences，levels of MAC and TSF in females were obviously increased compared with those before Ensure Nutrison nasal feeding，but no difference in levels of MAC and TSF was observed in males. There was no obvious increase in gastrointenstional reaction and electrolytes disturbance incidence and the blood glucose was basically normal before and after Ensure Nutrison nasal feeding. Conclusions：Enteral nutrition agent of Ensure Nutrison can improve multiple nutrition indicators of elderly patients with nasal feed－ing without increasing gastrointestinal reactions and electrolyte disorders.