早期胃肠内营养支持对重型颅脑损伤患者预后的影响

目的探讨对重型颅脑损伤患者行早期胃肠内营养支持的临床价值。方法将同期收治的104例重型颅脑损伤患者随机分为观察组与对照组各52例,两组入院后均根据病情行常规治疗,在此基础上观察组于伤后24h内经十二指肠置管行早期胃肠内营养支持,24 h内予米汤或鸡蛋糊,48 h后予能全力;对照组入院至伤后1周行完全胃肠外营养,伤后约1周肠鸣音出现时鼻饲能全力。治疗后28 d观察两组急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及并发症发生情况,抽取空腹静脉血检测血生化指标包括血清总蛋白、白蛋白、Hb及总淋巴细胞计数、空腹血糖、氮平衡。结果观察组APACHEⅡ评分及并发症发生率均显著低于对照组,TP、Alb、Hb、氮平衡等血生化指标均优于对照组（P均〈0.05）。结论对重型颅脑损伤患者行早期胃肠内营养支持可通过改善全身营养及免疫状况等改善预后、降低并发症发生率,且具有操作简单、安全、方便、费用相对低廉等优点。

Effects of early enteral nutrition on the prognosis of patients with severe craniocerebral injury

Objective To investigate the clinical value of early enteral nutrition on the patients with craniocerebral injury.Methods One hundred and four cases o f severe craniocerebral injury were randomly divided into observed group and con trol group with 52 in each,both groups were given routine treatment according to the condition,furthermore the observed group received enteral nutrition through duodenum nutrition tube within 24 h（rice water or egg paste within 24 h,nutriso n fibre after 48 h）;the control group was given PN and vutrison fibre after a we ek.The APACHE Ⅱ score and complications were observed 28 ds after the treatment,and the TP,Alb,Hb and TLC,fasting plasma glucose,nitrogen balance.Results Th e APACHE Ⅱ score and complications of the observed group were lower than those of the control group,the TP,Alb,Hb and nitrogen balance and so on were all supe rior to those of the control group（all P0.05）.Conclusions Early enteral nutriti on can improve the prognosis of severe craniocerebral injury patients by improvi ng nutrition and immune states,and has the advantage such as simplicity,safe an d convenience.