早期肠内营养+肠外营养支持在重型颅脑损伤患者中的应用

目的:探讨早期营养支持对重型颅脑损伤病人营养状况及并发症的影响。方法:ICU内56例重型颅脑损伤患者随机分为肠内营养(EN) 肠外营养(PN)组(28例)和PN组(28例),EN PN组伤后即实施PN,入院后早期(24h)开始应用EN,并逐渐加量,不足部分以PN补充,PN组伤后即实施PN,期间监测两组病人的上臂肌围、血糖、血浆白蛋白、血红蛋白,同时观察并发症发生率。结果:EN PN组在血清白蛋白和血红蛋白增高方面优于PN组(P<0.05),EN PN组病例营养状态明显好于PN组(P<0.01),并发症减少,预后良好。结论:对于重型颅脑损伤病患者,早期EN PN可以明显改善营养状况,减少并发症的发生。

Application of Early Enteral and Parenteral Nutrition Support in Patients with Severe Craniocerebral Trauma

Objective:To explore the methods and rationality of early enteral and parenteral nutrition support in severe head injury patients.Methods:The severa head injury patients in ICU were divided randomly into EN PN group(28 cases)and PN group(28 cas- es).The EN PN group received PN after injury,appled enteral nutrition after admission,insufficient part associated with parenteral nutrition and the PN group were supported with parenteral nutrition.A variety of indications of arm muscle circumference,blood glu- cose,plasma-albumin,hemoglobin,nitrogen balance were examined.At the same time,the complication during treatment were ob- served and the prognosis were judged.Results:Differences were observed between the two groups and EN PN group were superior to PN group.The plasma-albumin in and hemoglobin in were increased(P<0.05).The nutrition state,complication and prognosis in EN PN group were more favorable than thoee in PN group(P<0.01).Conclusion:Early EN PN treatment in patients with serve brain injury can reduce incidence of alimentary tract hemorrhage and complication.It was beneficial to improve the gut constit and func- tion.Also the early EN PN treatment can reduce infection rate and promote early recovery.