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谷氨酰胺对老年髋部骨折患者术后早期营养支持耐受性及炎症反应的影响
Effect of glutamine fortified enteral nutrition preparation on tolerance of early postoperative nutritional support and inflammatory response in the elderly after hip fracture surgery
- 第三军医大学学报 2021年43卷第20期 页码：2250-2254
- 作者机构：
1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院骨科
2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院营养科
- 作者简介：
[ 张玉梅，E-mail：zhangyumei19693@sina.com ZHANG Yumei, E-mail: zhangyumei19693@sina.com
- 基金信息：国家自然基金青年科学基金项目(81602855);陆军军医大学护理创新基金项目(2020m09)
DOI：10.16016/j.1000-5404.202105008
中图分类号： R459.3;R683.3;R977.4收稿：2021-05-06，
修回：2021-05-21，
纸质出版：2021-10-30
- 稿件说明：
移动端阅览
何永琴, 黄陈, 冯筱青, 等. 谷氨酰胺对老年髋部骨折患者术后早期营养支持耐受性及炎症反应的影响[J]. 第三军医大学学报, 2021,43(20):2250-2254.
Yongqin HE, Chen HUANG, Xiaoqing FENG, et al. Effect of glutamine fortified enteral nutrition preparation on tolerance of early postoperative nutritional support and inflammatory response in the elderly after hip fracture surgery[J]. Journal of Third Military Medical University, 2021, 43(20): 2250-2254.
何永琴, 黄陈, 冯筱青, 等. 谷氨酰胺对老年髋部骨折患者术后早期营养支持耐受性及炎症反应的影响[J]. 第三军医大学学报, 2021,43(20):2250-2254. DOI： 10.16016/j.1000-5404.202105008.
Yongqin HE, Chen HUANG, Xiaoqing FENG, et al. Effect of glutamine fortified enteral nutrition preparation on tolerance of early postoperative nutritional support and inflammatory response in the elderly after hip fracture surgery[J]. Journal of Third Military Medical University, 2021, 43(20): 2250-2254. DOI： 10.16016/j.1000-5404.202105008.
摘要
目的
2
评价强化谷氨酰胺的肠内营养制剂对老年髋部骨折患者术后早期营养支持的耐受性及炎症反应的影响。
方法
2
纳入2019年1月至2020年12月因髋部骨折收入我科的老年患者113例，按入院顺序进行分组，对照组57例，观察组56例。比较两组患者术后恶心呕吐发生情况，术后肛门首次排气时间，术后首次进食时间，手术前后1 h口渴/饥饿视觉量表评分，术后第3天血清总蛋白、白蛋白、中性粒细胞百分率、C反应蛋白及白细胞水平。
结果
2
两组患者术中均未发生返流误吸等事件；手术前后1 h口渴视觉量表评分，术前1 h饥饿视觉量表评分，术后第3天血清总蛋白、白蛋白两组比较差异无统计学意义；观察组术后第3天C反应蛋白水平较对照组低(
P
<
0.05)；观察组术后肛门首次排气时间、首次进食时间显著缩短(
P
<
0.01)；观察组术后1 h饥饿程度高于对照组，术后恶心呕吐发生率低于对照组(
P
<
0.05)。
结论
2
老年髋部骨折患者辅助强化的谷氨酰胺营养干预方案有助于提高术后早期肠内营养耐受性，减轻炎症反应。
Abstract
Objective
2
To determine the effects of glutamine-enhanced nutritional intervention on the tolerance of early postoperative nutritional support and on the inflammatory response in elderly patients after hip fracture surgery.
Methods
2
A total of 113 elderly patients admitted to our hospital due to hip fracture from January 2019 to December 2020 were recruited in this study. According to the order of admission
they were divided into control group (
n
=57
routine nutrition intervention) and experimental group (
n
=56
nutritional intervention program with adjuvant glutamine enhancement). The incidences of postoperative nausea and vomiting
first postoperative anal exhaust time
first postoperative feeding time
thirst/hunger visual scale scores in 1 h before and after surgery
and serum levels of total protein
albumin and C-reactive protein
neutrophil percentage and white blood cell count on the third day after surgery were compared between the 2 groups.
Results
2
No reflux aspiration occurred in the both groups. There were no statistical differences between the 2 groups in the preoperative and postoperative 1-hour scores of thirst vision scale
preoperative 1-hour score of hunger vision scale
and the serum levels of total protein and albumin on the third postoperative day. The experimental group had significantly lower C-reactive protein level on the third day after operation (
P
<
0.05)
earlier first exhaust of anus and first fee
ding (
P
<
0.01)
higher postoperative 1-hour score of hunger vision scale (
P
<
0.05)
and lower incidences of nausea and vomiting (
P
<
0.05) when compared with the control group.
Conclusion
2
The adjuvant fortified glutamine nutrition intervention program is helpful to improve the early postoperative enteral nutrition tolerance and to reduce postoperative inflammatory response in elderly patients after hip fracture surgery.
关键词
Keywords
references
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