肠外和肠内贯序营养支持对急性脑出血早期预后的影响

目的探讨肠外和肠内贯序营养支持对急性脑出血早期预后的影响.方法将出血量为40～70ml,GCS评分<7分的急性脑出血50例随机分为A组( 肠内和肠外贯序营养方法),B组(肠外营养).从起病48h后开始给予营养支持,观察营养支持治疗2周后的住院病死率、并发症发生率、意识状态(GCS评分)、运动功能(FMA)和运动能力(MBI)的变化.结果肠外和肠内贯序营养在病死率和意识程度改善、多脏器功能衰竭和感染并发症的发生率及肢体运动功能和生活自理能力的恢复上明显优于单纯肠外营养.结论肠外和肠内贯序营养是根据机体代谢变化采用的阶段性合理安全的营养支持方法,对改善急性脑出血的早期预后具有重要的临床价值.

The effects of parenteral and enteral nutrition in sequence on early prognosis of acute cerebral hemorrhage

Objective To study the effects of parenteral and enteral nutrition in sequence on early prognosis of acute cerebral hemorrhage.Methods Fifty cases of acute cerebral hemorrhage with the volume of 40 to 70 ml and CGS<7 were randomly divided into group A (parenteral and enteral nutrition in sequence) and group B (parenteral nutrition).Nutritional support was started 48 hours after the illness.The hospitalized mortality,the rate of complications,the consciousness status (CGS),the motor functions (FMA) and the motor ability (MBI) after 2 weeks of nutritional support were observed.Results The mortality was decreased,the consciousness status was improved,the complications of MOF and infections were decreased,the motor functions and the motor ability were improved in the group of parenteral and enteral nutrition in sequence compared with the group of simple parenteral nutrition.Conclusion The parenteral and enteral nutrition in sequence is a staggered,reasonable and safe nutritional supporting method according to the changes of metabolism.It values a clinical importance in improving early prognosis of acute cerebral hemorrhage.