小儿重型颅脑损伤早期肠内营养支持临床疗效观察

目的:探讨早期肠内营养支持对重型颅脑损伤患儿的临床疗效。方法:选取2015年1月—2018年6月我院收治的重型颅脑损伤患儿96例作为研究资料，使用雀巢小百肽经鼻空肠管给予患儿营养支持，于肠内营养（EN）前、肠内营养1周后、肠内营养4周后分别采血分析营养指标水平，测量患儿体质量，上臂肌围。观察本组预后情况及胃肠道不良反应发生情况。结果:本组96例患儿，经过治疗及相关护理、肠内营养支持后，82例恢复良好，7例致残，2例植物生存，5例死亡。患儿经肠内营养支持后1周，除血红蛋白（Hb）外，血清白蛋白（ALB）、血清总蛋白（TP）、体质量、上臂肌围与肠内营养支持前无显著性差异（P>0.05），肠内营养支持4周后，ALB、TP、Hb、体质量、上臂肌围等水平均高于肠内营养支持前，差异显著（P<0.05）。结论:早期肠内营养支持应用于小儿重型颅脑损伤患儿，可迅速扭转机体负氮平衡，提高患儿营养水平，保护消化道功能，安全性高，并发症少，有利于疾病康复，对患儿预后具有积极意义。

Clinical observation of early enteral nutrition support in children with severe craniocerebral injury

Objective: To investigate the clinical effect of early enteral nutrition support on children with severe traumatic brain injury. Methods:Ninety-six children with severe traumatic brain injury admitted to our hospital from January 2015 to June 2018 were selected as the research subjects. Nestle Peptamen Junior was used to provide nutritional support through nose/jejunum tube. Blood samples were collected before enteral nutrition(EN), one week after enteral nutrition and four weeks after enteral nutrition to analyze nutritional indicators, and to measure the body weight and upper arm muscle circumference of the children. The prognosis and adverse reactions of gastrointestinal tract were observed. Results:After treatment, nursing and enteral nutrition support, 82 cases recovered well, 7 cases were disabled, 2 cases survived and 5 cases were passed. One week after enteral nutrition support, except for hemoglobin (Hb), there were no significant differences in serum albumin (ALB), total serum protein(TP), body weight, upper arm muscle circumference than before enteral nutrition support(P > 0.05). Four weeks after enteral nutrition support, the levels of ALB, TP, Hb, body weight and upper arm muscle circumference were higher than before enteral nutrition support(P < 0.05). Conclusion:Early enteral nutrition support in children with severe traumatic brain injury can quickly reverse negative nitrogen balance, improve nutritional level, protect digestive tract function, with high safety and fewer complications. It is crucial for to disease rehabilitation and has positive significance for the prognosis of children.