生长激素加早期肠内营养对高血压脑出血病人术后营养状况及并发症的影响

目的:探讨生长激素(GH)加早期肠内营养对高血压脑出血(HICH)病人术后营养状况及并发症的影响.方法:将122例高血压脑出血术后病人随机分成治疗组和对照组,每组61例.治疗组术后第2天开始肠内营养(EN)支持,同时每天联合应用GH,连用1周.对照组术后第2天开始胃肠外营养(TPN)支持.测定手术当天、术后第2天(营养支持第1天)和第3、7、14、21天的多项营养指标,并观察两组的临床疗效和并发症.结果:治疗组血清前清蛋白、转铁蛋白、清蛋白和氮平衡均明显高于对照组(P＜0.05);治疗组肺部感染、应激性溃疡和电解质紊乱发生率明显低于对照组(P＜0.05～0.01);治疗组平均入住ICU时间明显短于对照组(P＜0.05);治疗组第21天GCS评分＞8分的病人百分率明显高于对照组(P＜0.01).结论:生长激素联合早期肠内营养不仅可迅速改善高血压脑出血术后病人的营养状况、减少并发症,而且可缩短入住ICU时间,提高临床疗效.

The effect of growth hormone added early enteral nutrition on nutritional status and complications in postoperative patients with hypertensive intra-cerebral hemorrhage

Objective: To explore the effects of growth hormone (GH) added early enteral nutrition(EEN) on nutrition status and complications in postoperative hypertensive intra-cerebral hemorrhage(HICH) patients.Methods: 122 patients with postoperative HICH were randomized into the treat group and control group. The treatment group (61 cases) received enteral nutrition support on the 2nd day after operation, and growth hormone was combined for one week. The control group (61 cases) received total parenteral nutrition(TPN) support. The clinical effect and complications were observed between the two groups. Results: The patientss serum pre-albumin , transferrin ,albumin , and nitrogen balance in the treatment group were significantly better than those in the control group (P<0.05). The incidences of pulmonary infection, stress-related gastric injury and electrolyte mess in the treatment group were significantly lower than those in the control group(P<0.05~0.01).Conclusion: Growth hormone combined early enteral nutrition can improve nutrition status and reduce complications.