早期肠内营养在重症监护室重型颅脑损伤中的临床研究

摘要

目的 探讨重症监护室重型颅脑损伤患者早期肠内营养的方法.方法 对41例重症监护室重型颅脑损伤患者随机分为对照组和观察组.对照组肠外营养支持;治疗组完全肠内营养支持.比较2组氮平衡(NB)、血清清蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TFN)、IgA、IgG、IgM以及肝、肾功能、血糖(GLU)和并发症等指标.结果 2组患者营养支持后NB、PA、TFN、IgA、IgG、IgM水平明显改善,而ALB、肝功能、肾功能、血糖水平无明显变化;治疗组NB、PA、IgA、IgM较对照组明显改善(P<0.05).结论 重症监护室重型颅脑损伤患者肠内营养,不仅可以改善患者全身代谢状况,减少负氮平衡,而且还能提高免疫功能.%Objective To explore a method of early enteral nutritional support for severe head injury patients in ICU. Methods Forty - one severe head injury patients in ICU were randomly divided into control group and observation group. The control group received parenteral nutrition. The observed group received enteral nutrition. Nitrogen balance, ALB, PA, TFN, IgA,IgG, IgM, hepatic and renal functions, GLU and complications in the two groups were compared.Results After nutritional support, NB, PA, TFN, IgA, IgG and IgM were better than those before nutritional support in two groups, while ALB, hepatic and renal functions and GLU saw no obvious changes. Nitrogen balance, PA, TFN, IgA, IgG and IgM were significantly improved in the observed group than those in the control group ( P ＜ 0.05). Conclusion Early enteral nutrition support can improve metabolic status, reduce the nitrogen balance and improve the immune function as a whole for sever head injury patients in ICU.