重度创伤患者使用精氨酸的安全性研究

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目的探讨精氨酸对重度创伤患者安全性的影响。方法选择简化损伤分级(AIS)-90创伤评分为16~25分的重度创伤患者37例,根据是否服用精氨酸随机分为对照组和精氨酸组(30 g/d),观察14d。采用等氮等热卡营养支持,术后1d、14d测定两组肝、肾功能,记录感染并发症和胃肠道症状,采用卡方检验、球形检验和独立样本t检验。结果精氨酸组、对照组术后14d丙氨酸转氨酶均显著高于术后1d,差异均有统计学意义(P=0.022,0.007),两组间比较差异亦有统计学意义(P=0.017)。精氨酸组术后14d尿素较术后1d升高,但差异无统计学意义(P>0.05);对照组术后14d较术后1d降低,但差异无统计学意义(P>0.05)。精氨酸组、对照组感染率分别为5.9%、25.0%,差异有统计学意义(P=0.009);两组各种胃肠道症状发生率差异无统计学意义(P>0.05)。结论 AIS-90创伤评分16~25分的重度创伤患者应用30 g/d精氨酸安全可靠。 Objective To investigate the effect of arginine on the safety of patients with severe trauma. Methods Thirty-seven patients with severe traumatic injury (AIS) -90 trauma score from 16 to 25 were randomly divided into control group and arginine group (30 g / d) according to whether taking arginine or not, and observed for 14 days. Hepatic and renal functions of two groups were measured on the 1st and 14th day after operation, and the complications of infection and gastrointestinal tract were recorded. The chi-square test, spherical test and independent sample t-test were used. Results The levels of alanine aminotransferase in the arginine group and the control group at 14th day after operation were all significantly higher than those at the first day after operation (P = 0.022,0.007). There was also a significant difference between the two groups (P = 0.017). The levels of urea in arginine group at 14 days after operation were significantly higher than those at 1 day after operation, but the difference was not statistically significant (P> 0.05). The control group at 14 days after operation was lower than that at 1 day after operation, but the difference was not statistically significant (P> 0.05). The infection rates of arginine group and control group were 5.9% and 25.0%, respectively, with significant difference (P = 0.009). There was no significant difference in the incidence of gastrointestinal symptoms between the two groups (P> 0.05). Conclusion Serious and trauma patients with AIS-90 trauma score of 16 to 25 were safe and reliable with 30 g / d arginine.
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