Comparative Study On Therapeutic Effect Of Enteral And Parentral Nutrition In The Critically Ill Patients

Objective:To evaluate the important effect on the critically ill patients with early and full enteral and parenteral nutrition treatment and the comparement of effects between those treatments on their nutrition condition,organ function and immne function.Methods:During the June of this year,the 124 critically ill patients whose APACHEII score were higher than 16 in the intensive care unit of our hospital were treated and randomly divided into enteral nutrition group,parentaral nutrition group, mixed nutrition group(patients treated by enteral and parentral nutrition simultaneously)and control group.Within 24～48 hours after admission,the patients in first three groups were cured with correspond nutrition supply and other treatments. The patients in control group were supplied energy only with food and glucose and cured with other treatments.The change of every groups patients' indexes,such as ALT,Cr,CK-MB,TNT,OB,nutrion condition index,TP,ALB,PA,HGB,immune function index,IgA,IgG,IgM,TLC,percentange of CD3 and CD4 and rate between CD4 and CD8,were observed before and 10 days later after treatment.All relevant data were entered into computer and dealed with the statistics software SPSS13.0. Comparing the means of two groups of sample whose mean square of measurement data was regular adopted t to analyse.Not regular adopted t'.Enumeration data adopted x~2 to analyse.Results:The indexes of ALT,Cr,CK-MB,TNT in control group were obviously higher than those in EN,PN and MIX groups(P＜0.05).There was no significant difference of ALT,Cr,CK-MB and TNT in the later three groups before and after treatment(P＞0.05),and there was no significant difference of ALT,Cr,CK-MB and TNT among these groups,also(P＞0.05).The indexes of ALB,PA,HGB of patients in EN and MIX groups were more increased than those in PN and control groups (P＜0.05),and the indexes in PN group were higher than those in control group (P＜0.05),and there was not significant difference between EN and MIX groups (P＜0.05).Incidence rate of alimentary tract hemorrhage in control and PN groups were 37%,which was higher than that in MIX group,10.8%,(P＜0.05).Otherwise,all of them were higher than incidence rate,6.45%,in EN group(P＜0.05).Changes of TLC and IgG in EN and MIX group were more obvious than PN and control group before and after treatment.CD4 and the rate between CD4 and CD8 increased obviously,also(P＜0.05).IgA,IgM and the percentage of CD3 have no obvious difference in all groups before and after treatment(P＜0.05).Conclusion:1.Malnutrion,immune dysfunction,and so on could been effectively prevented with early nutrition supply on the critically ill patients.2.Parentral nutrition treatment have more obvious curative effects on protecting hepar,kidney and myocardial function,improving nutrition condition of the patients and preventing immune dysfunction.3.The treatment with enteral nutrition has more advantage than that with parenteral nutrition or single glucose,which could protect gastrointestinal tract and other important organs,prevent displacement of bacteria and its toxin,release infection reaction of whole body and improve nutrition condition of the patients and immune function.