重型颅脑损伤的早期肠内辅以肠外营养支持

目的 探讨重型颅脑损伤病人实施早期持续滴注鼻饲胃肠营养的合理应用及临床效果。方法 将符合条件的患者随机分为治疗组和对照组，治疗组34例实施持续滴注鼻饲胃肠营养辅以肠外营养，对照组32例按传统方法鼻饲流质。期间检测血生化指标和氮平衡，同时观察各组在治疗中并发症发生情况，出院时进行统计和预后判断。结果 病人能较好耐受早期胃肠道营养，治疗组的营养指标、氮平衡、并发症及预后均明显优于对照组。结论 持续滴注的鼻饲胃肠道营养辅以部分肠外补充的方法切实可行，能够提供足够的营养物质，对维护胃肠功能、减少感染、促进神经功能恢复和降低死亡率都有意义。

Early enteral nutritional support associated with parenteral nutrition in patients with severe craniocerebral trauma

Objective To explore the reasonable application and clinical effects of early enteral nutritional support associated with parenteral nutrition in severe head injury patients. Methods The severe head injury patients were divided randomly into treatment group and control group. The treatment group (34 cases) received early persistent pernasal instillation associated with parenteral nutrition and the control group (32 cases) was supported with conventional method. A variety of indications of blood biochemistry, and nitrogen balance were examined. At the same time, the complications during treatment were observed and the prognosis were judged. All data were statistically analyzed. Results Early enteral feeding using small nasogastric tube were tolerated better than previous method. The nutrition indices, nitrogen balance, complications and prognosis in treatment group were more favorable than those in control group. Conclusion The method of persistent nasogastric feeding with accessorial parenteral nutrition is feasible. The application of enough nutrition is beneficial to improve the gut function and the neurologic condition. Also the early nutrition support can reduce infection rate and mortality.