| OBJECTIVE①To observe the effective route for administering nutrition on the severe trauma patients in the short-term.②To seek the sensitive nutrition assessment marker on the severe trauma patients in the short-term.METHODS According to pathogenetic condition, 36 severe trauma patients who understand and agree this study were assigned to parenteral nutrition (PN, n=18) group and enteral nutrition (EN, n=18) group. Based on the individual difference of patient, to supply individual caloric. The total caloric of supply is Harris-Benedict formula×1.1～1.2, or 20～25 kcal/kg·d-1 when the Harris-Benedict formula could not calculate. The nutritional support time more than 7 days. The total protein (TP), albumin (ALB), transferrin (TFN) and prealbumin (PA) were measured at before nutritional support (day 0) and after nutritional support (day 2 and day 7) in all patients. Observation the changes of above-mentioned protein in blood-serum, find the effective route for administering nutrition and nutrition assessment marker.RESULTS In short-term (7 days),①At PN group, no significantd deviation was found in the level of TP and ALB among of day 0, day 2 and day 7(P＞0.05); no significant deviation was found in the level of TFN between day 0 and day 2(P>0.05), a significant deviation was found in the level of TFN at day 7 vs. day 0 and day 7 vs. day 2 (P＜0.05); a significant deviation was found in the level of PA among of day 0, day 2 and day 7(P＜0.05).②At EN group, no significant deviation was found in the level of TP and ALB among of day 0, day 2 and day 7( P＞0.05); no significant deviation was found in the level of TFN and PA between day 0 and day 2(P＞0.05); a significant deviation was found in the level of TFN and PA at day 7 vs. day 0 and day 7 vs. day 2(P＜0.05).③At main effect of grouping factor, no significant deviation was found in the level of TP and ALB at different nutritional support time (P＞0.05), a significant deviation was found in the level of TFN and PA at different nutritional support time (P＜0.05).④At main effect of time factor, no significant deviation was found in the level of TP, ALB, TFN and PA in different group (P＞0.05).⑤There are no crossover effect between of grouping factor and time factor (P＞0.05). CONCLUSIONS①The PN and EN can improve the nutritional state on the severe trauma patients in short-term, they are correct route for administering nutrition, we can according pathogenetic condition to choose it in clinical.②TFN and PA are all sensitive marker to evaluate the effect of nutritional support in short-term, but the PA is more sensitiv than TFN.③TP and ALB could not objectively evaluate the effect of nutritional support in short-term. |
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