摘要：目的对1998年以来临床28例危重病人，实施达到营养目标的肠内营养支持，并做了短期疗效观察。方法1．依病情需要分TEN管饲匀浆膳、要素膳组(一组)9例，外科6例，内科3例，支持时间平均25．8天。EN+PN组(二组)9例，外科7例，内科2例，支持时间平均22．1天。口服营养补充剂组(三组)10例，外科7例，内科3例，支持时间平均16．1天。每日摄人热能以BEE×活动系数×应激系数公式计算，蛋白质平均1．2g／kg，脂肪平均占25％，碳水化物平均占55％。维生素、矿物质、微量元素以RDA计算。2．营养目标：①恢复或保持血浆白蛋白正常水平。②降低异常或保持血糖正常水平。③纠正电解质平衡紊乱。结果短期内血浆白蛋白达标率分别为：89％、78％、80％，血糖达标率为：89％、86％、80％，离子达标率为：K78％、100％、80％，Na89％、88％、90％，Cl100％、88％、100％，Ca89％、100％、100％，P100％、100％、100％o结论虽然三组各自的应用范围不同，但只要有明确的营养目标，各组血浆白蛋白、血糖、血清离子在短期内都会取得显著改善，有效地提高疾病临床治愈率。应注意的是在临床实际应用时，为防止正常血糖、离子等的异常变化，营养医师应及时了解病情动态，随时调整个体化的营养素配方。

The short term effect of enteral nutrition support which achieve the nutritional goal on criticalpatients

lU Li,LIU Qingchun,LI Ying(Nutriology Department, General Hospital of Chinese People Armed Police Army, Beijing, 100039)

Abstract：Objeetvie Enteral nutrition support which achieve the nutritional goal was applied in 28 clinical critical patients Imm 1998 in our hospital and the short term effect was observed. Methods 1. The patients were divided into three groups according to the paTIENT' S condition, A group of 9 eases of intubation feeding with homogenate meal and elemental diet (the first group), 6 are surgical patients and 3 are internaldept patients, average duration is 26 days. A group of 10 cases with oral nutrition supplement (the third group), 7 are surgical patients and 3 are medical patients,average duration is 16 days. Daily energy intake is calculated with the formula: BEE x coefficient of activity x coefficient of stress. Daily protein intake is calculated with 1.2g/kg, daily average intake of fat is 28 % of the energy and carbohydrate is 55 %. Vitamin,mineral and microelements are calculated with the RDA. 2. Short to. rrn goal. ① Serum albumin level is renewed or kept normal. ② Serum glucose level is reduced lower or kept normal. ③ Electrolyte balance. Results The short term effection: Achieving goal rate of serum albumin: 89 %, 78 %, 80 %. Achieving goal rate of serum glucose: 89 %, 86 % , 80 %. Achieving goal rate of electrolyte: K 78 %, 100 %, 80 %. Na 89 %, 88 %, 90 %, Cl 100 %, 88 %,100 %. Ca 89 %,100 %, 100. P 100 %, 100 %, 100 %. Conclusions Although the applying rangs of the three groups are different, there is explict nutritional goal, the serum albumin、glucose、electrolyte will make a notable achievement in short time. While applying nutrition support in clinical practice, nutritional doctor should know cell the change of the patient's condition and adjust individual prescription of nutriment at any time so at to prevent the abnormal change of the serum glucose and electrolytes from the patients.