Clinical Study Of Nutritional Support Therapy For Critically Ill Patients

Critically ill patients will change the metabolic characteristics in high stress state, catabolism acceleration and anabolic restricted, in demand for energy and nutrients of the body will increase, but the body itself cannot meet the requirement at this time, must rely on organs of exogenous supply nutrients to maintain the normal structure and function, and prevent the occurrence of multiple organ failure. So the nutrition support occupies important position in the treatment of critically ill patients and more and more clinical doctors began to pay attention to this.Although the scholars at home and abroad through years of effort and a large number of clinical studies, ac-hievede a lot of achievements in the field of nutrition support, but due to the particularity of critically ill patients with metabolism, some aspects of the research aboat nutritional support is still in the exploratory stage. Especially the research of TCM (Traditional Chinese Medicine) in nutrition support is less.According to a survey at home, we found that the risk of malnutrition exsisted in most of patients, although they received nutrition support treatment.We also found that their nutrition indicators falled when the patients get out of the hospital[1]. This study has shown that many patients have not been effective nutrition support, also reflects the understanding of the clinical medical staff to nutritional support is not enough.Sometimes it is difficult to improve its prognosis for the critically ill patient who received positive nutrition support. This is because the nutrition support the same as that other treatments, it needs the combination of universality and individuality to get better results. Therefore, it is necessary according to the needs of the patient’s condi tion to set an individualized and periodic nutriational support plan and conduct a reasonable nutrition support.Objective40 cases of critically ill patients in the ICU, first, evaluate their nutritional status when into the ICU, and give nutrition assessment again after 7-28 days’routine treatment plus nutritional support treatment, observe their nutrition index changes, nutritional status and clinical outcome, verify the importance of nutritional support in critical care treatment, and explore critical nutrition improve sensitivity indexMethodsChoice for 40 cases of critically ill patients who could not through the mouth to eat and need nutrition support.combined with the illness needs, giving them reasonable nutrition support. As follows:(1) Compare the patients’nutritional status and nutritional indexes difference between just enter the ICU and out of the ICU; (2) according to the characteristics of different symptoms, they are divided into deficiency syndrome group and excess syndrome group, and compare the difference between two groups of patients’NRS2002 score, APACHEII score and age when enter the ICU; Compare the difference between two groups of patients’ the nutrition indicators; Compare the actual situation of the relationship between symptoms and clinical outcomes; (3)Observe the correlation between serum albumin level、 NRS2002 score and APACHEII scores enter the ICU; (4)Compare the difference between serum albumin、NRS score、APACHE Ⅱ score and C-reactive prote in different clinical outcome patients enter the ICU.ResultsThe results showed that:(1) Compare the nutritional indexes 40 cases of the critically ill patients just enter the ICU and at the time out of the ICU, C-reactive protein, lymphocyte count, serum total protein, serum albumin levels had no statistical significance (P>0.05); NRS-2002 score, serum prealbumin, transferrin, blood urea nitrogen level had significant difference (P< 0.05). Among them, only NRS2002 score declined, but other indexes elevated when out of the ICU; Hemoglobin levels had significant difference (P< 0.001), It decreased significantly when get out of ICU; (2) Comare the defference between deficiency syndrome group and excess syndrome group, NRS2002 score level had significant difference (P< 0.05), NRS score level deficiency syndrome group was obviously higher than that of excess syndrome group; Age, APACHE Ⅱ score between two groups, C-reactive protein, lymphocyte count, hemoglobin content, serum total protein, serum albumin, prealbumin, transferrin, comparison and so on had no statistical difference (P> 0.05); (3) Deficiency syndrome group of mortality is higher than group of excess syndrome; (4) There is a negative correlation between serum albumin level and NRS2002 score; no correlation between Serum albumin and APACHE Ⅱ score, NRS score and APACHEII scores; Two different clinical outcomes of patients, CRP and NRS score had statistically difference (P< 0.05), and higher in death than in survival group; serum albumin and APACHEⅡ no statistical difference between two groups of patients.Therefore, reasonable nutrition support can improve the nutritional status of critically ill patients. Deficiency syndrome patient mortality is higher than group of excess syndrome.