重型颅脑损伤患者超早期行肠内营养支持的效果分析

摘要

Objective To explore the early effect of super early enteral nutrition support in patients with se -vere craniocerebral injury.Methods According to the hospitalized single or double number ,60 patients were divided into treatment group and control group , 30 patients in each group.the control group with was treated conventional therapy.The treatment group received supwer early enteral nutrition support , the efficacy of blood biochemical indica-tors, complications and prognosis were observed and compared .Results At third week after treatment,the dicreased values in body weight(BW), triceps skinfold(TSF), arm muscle circumference(AMC), NB(g/d) in the treatment group were less than those control group (P<0.05).The levels of albumin, hemoglobin serum protein and the GOS scores in the treatment group were higher than those in the control group (P<0.05), the incidence in pulmonary in-fection, abdominal distension, diarrhea, gastrointestinal bleeding and the mortality rates in the treatment group were lower than those in the control group (P<0.01 or P<0.05).Conclusion For patients with severe craniocerebral in -jury,super early enteral nutrition support can promote recovery , improve nitrogen balance and the nutritional status of the patients, help neural function defect rehabilitation and synthesis of skeletal muscle , improve immunity, thereby reducing the pulmonary infection and other complications , reducing the mortality rate.%目的探讨重型颅脑损伤患者超早期行肠内营养支持的治疗效果。方法将60例患者按住院单双号分为治疗组和对照组，每组30例，对照组采用常规支持治疗，治疗组于超早期行肠内营养支持治疗，观察比较两组疗效、血生化指标、并发症和预后等情况。结果治疗3周后对患者进行检查，治疗组的体重（BW）、肱三头肌皮皱厚度（TSF）、上臂肌围（AMC）、平衡NB（g/d ）的减少值均大于对照组（P＜0.05），治疗组的血清白蛋白、血红蛋白、血清前白蛋白及格拉斯哥昏迷指数（GOS）评分均高于对照组（P＜0.05），治疗组消化道出血的发生率和病死率均低于对照组（P＜0.01或＜0.05）。结论重型颅脑损伤患者超早期行肠内营养支持可以改善氮平衡，改善患者营养状况，有利于神经功能缺损的康复和骨骼肌的合成，提高机体的免疫力，从而降低消化道出血率和病死率，值得临床推广应用。