重症脑外伤早期肠内与肠外营养支持的血糖及胰岛素水平对比

目的对比重症脑外伤后早期肠内与肠外营养支持的血糖及胰岛素水平差异。方法将重症脑外伤病人随机分为早期胃肠道营养组(EEF组)和早期完全胃肠外营养组(TPN组)，对比营养支持前后两组血糖及胰岛素水平的差异。结果两组在伤后第1、3、6天血糖及胰岛素水平显著升高(P＜0.01)，伤后第3天TPN组及EEF组血糖及胰岛素水平达到高峰，伤后第14天两组血糖及胰岛素水平恢复正常范围。EEF组的血糖及胰岛素水平在伤后第3、6天显著低于TPN组(P＜0.05)，伤后第1、14天两组的空腹血糖及胰岛素水平无显著差异(P＞0.05)。结论早期胃肠道营养支持对比胃肠外营养支持可更好地减轻重症脑损伤后的高血糖反应及胰岛素水平。

Comparison with serumsugar and insulin on early nasogastric feeding versus parenteral nutrition in severe brain- injuried patients

Objective The present study evaluates the difference of serum sugar on early nasogastric feeding venus parenteral nutrition in severe brain - injured patients. Method In the prospective clinical study, the patients with severe brain - injury were randomly divided into early enteral feeding group(EEFg), and total parental nutrition group(TPNg). Blood sugar and insulin were compared between the two groups after nutritional support. Result Serum glucose, insulin were increased after injury. Hyperglycermia of two groups and hyperinsulinemia of TPNg reach peak 3 day after tinjury. At this time, serum glucose, insulin in EEFg were significantly lower than that of TPNg. Serum glucose, insulin in the two groups relapse to normal range 14 day after tinjury. Conclusion As compared with parenteral nutrition, early nasogastric feeding reduced the hyperglycermia and hyperinsulinemia better in severe brain - injuried patients in the study.