早期肠内营养和肠外营养支持重型颅脑损伤的效果观察

目的探讨早期营养支持对重型颅脑损伤患者营养状况的效果影响。方法回顾性分析我院2004年1月～2008年10月间收治的重型颅脑损伤患者38例,随机分为肠内营养加肠外营养支持组(观察组)19例和全肠外营养支持组(对照组)19例。观察组早期肠内营养(enteral nutrition,EN)和肠外营养(parenteral nutrition,PN)结合,10天后转为全肠道营养,对照组10天内行全肠外营养支持,观察血糖、血浆白蛋白、淋巴细胞计数,并发症发生率及预后。结果观察组能获得充足的能量和蛋白质合成物,1周时的血糖控制程度、血浆白蛋白及外周血淋巴细胞总数优于对照组(P<0.05),观察组并发症少于对照组。观察组10天后病死率为(15.79%)明显低于对照组(31.58%)。结论重型颅脑损伤行早期肠内营养和肠外营养结合符合病人的病理、生理要求,能使该类病人营养状况和生存率提高。

Observation of Early Enteral Nutrition and Parenteral Nutrition Support for the Patients of Severe Head Injury

Objective:To study the effect of early nutritional support of patients with severe brain injury.Methods:Retrospectively analyse 38 patients with severe head injury in our hospital from January 2004 to October 2008.19 cases were divided into parenteral nutrition plus enteral nutrition support group(observation group),and 19 cases of total parenteral nutrition support group(control group).Patients inobserveation group were given early enteral nutrition(enteral nutrition,EN),parenteral nutrition(parenteral nutrition,PN) and total parenteral nutrition after 10 days,while the patients in control group were given total parenteral nutrition support in 10 days so as to observe the blood glucose,plasma white protein,lymphocyte count,incidence of complications and prognosis.Results:The patients in observation group were able to receive adequate energy and protein compounds,with the degree of glycemic control,plasma albumin and the total number of peripheral blood lymphocytes better than those in the control group after one week(P <0.05),complications lower than those in the control group.The fatality rate 10 days later in the observation group(15.79%) was significantly lower than that in the control group(31.58%).Conclusion:The early enteral nutrition and parenteral nutrition for patients with severe head injury combined with the pathological and physiological requirements can improve their nutritional status and survival rates.