严重脑损伤后早期肠内营养支持的合理应用

目的：传统的鼻饲营养方法因脑损伤胃动力下降早期难以安全实施。本研究对４１例严重脑损伤病人实施改良后的早期鼻饲喂养计划，观察其应用的合理性和临床效果。方法：实验组采用了早期鼻饲要素膳，对照组按常规方法实施鼻饲营养支持；实验组开始时间为伤后４８ｈ，对照组为伤后６－８天。

The rationalities for early nasogastric feeding after severe head injury

Objectives:Patients with severe brain injures require nutritional support becease of an accelerated metabolism and prolonged inability to eat.Because of the high incidence of gastropareis,enteral nutritiona support of patient with acute head injury has traditionally been difficult.This study evaduated that tolerance and effect of modified nasogastric feeding as early nutritional aupport in 41 severe head injuried patients. Methods:The study group(41 cases) was fed gastrically with the element diet and the control group(39 cases) was nutritional supported with common method.The enteral feeding was started within 48 h post injury for study group versus 6 to 8 days for control group. Results:Evidence indicates that aggressive early enteral feeding regimens using small nasogastric tude were tolerared better than previously believed.As compared with control group,the nitrogen balance,serum albumin,ICr,body weight,were signficantly better in the patients with nasogastric feeding after injury( P <0.05~ P <0.01). Conclusions:The modified gastric feeding is helpful to the early nutrition and beneficial to improve gut function and the nutritional condition of the severe head injured patients.