Jones D C, Rich A J, Wright P D, Johnston I D
Br Med J. 1980 Jun 21;280(6230):1493-5. doi: 10.1136/bmj.280.6230.1493.
Forty men who had sustained head injury were randomly assigned to one of five groups to receive 0.2 g nitrogen/kg body weight/day as either an elemental or a whole-protein diet. Three proprietary elemental and two whole-protein diets were compared. The mean daily nitrogen intake was below 0.2 g/kg in all groups, and was significantly lower in the groups receiving elemental compared with whole-protein diets. Energy intake was significantly different only between one group receiving an elemental and one receiving a whole-protein diet. Mean daily urinary nitrogen excretion was significantly lower in the groups receiving elemental diets, and mean daily nitrogen balance was negative in all groups except one receiving a whole-protein diet. Reduced nitrogen intakes occurred particularly with the elemental diets, which often provoked reflex vomiting or gastric stasis. The need to introduce diets at reduced strength made a negative balance almost inevitable, but nutritional balance seemed to be more readily achieved with the whole-protein diets. More work is needed to assess the relative merits of these proprietary diets compared with tube feeds prepared in hospitals.
40名头部受伤的男性被随机分配到五组中的一组，以接受0.2克氮/千克体重/天的元素饮食或全蛋白饮食。比较了三种专利元素饮食和两种全蛋白饮食。所有组的平均每日氮摄入量均低于0.2克/千克，与全蛋白饮食组相比，接受元素饮食组的氮摄入量显著更低。仅在一组接受元素饮食和一组接受全蛋白饮食之间，能量摄入量存在显著差异。接受元素饮食组的平均每日尿氮排泄量显著更低，除了一组接受全蛋白饮食的患者外，所有组的平均每日氮平衡均为负。特别是元素饮食会导致氮摄入量减少，这常常引发反射性呕吐或胃潴留。以较低强度引入饮食的必要性使得负平衡几乎不可避免，但全蛋白饮食似乎更容易实现营养平衡。与医院配制的管饲饮食相比，需要更多的研究来评估这些专利饮食的相对优点。
