早期肠内营养对重型颅脑损伤患者胃黏膜pH及血清蛋白的影响

目的探讨早期肠内营养（EN）对重型颅脑损伤患者胃黏膜pH（pH i）及血清蛋白的影响。方法通过连续监测患者伤后或术后5 d内pH i和血清蛋白水平的改变,根据生命体征和肠鸣音的恢复情况分别于12-72 h内给予EN（EN组）和静脉营养（PN组）。结果第5天EN组患者的pH i和血清蛋白水平比第1天增加（P〈0.05）,且明显高于PN组（P〈0.05）。此外,EN组患者较PN组恢复肛门排气时间明显缩短（P〈0.05）。结论早期EN的实施可以改善重型颅脑损伤患者的胃肠黏膜血液灌注及氧合状态,改善营养状况,有效防止肠道细菌移位的发生。

Effect of early enteral nutrition on intramucosal pH and serum protein in patients with severe head injury

Objective To study the changes of intramucosal pH（pHi） and serum protein levels after early enteral nutrition in patients with severe craniocerebral injury.Methods According to the vital signs and intestinal sounds,enteral nutrition（EN） and parenteral nutrition（PN） were respectively given to the patients 12 to 72 h after operation.The value of pHi was monitored continuously in the following 5 days.Results The value of pHi and serum protein levels increased in both groups on the 5th day after operation （ P 〈 0.05 ）. Moreover, the value of phi and serum protein levels of EN group increased more than that of PN group （ P 〈 0.05 ）. The restoration of anal exhaust time of EN group shortened significantly than that of PN group （P 〈 0.05）. Conclusion The use of early enteral nutrition can improve the blood perfusion and oxygenation of gastrointestinal mucosae as well as the nutritional status in severe craniocerebral injury patients.