早期鼻饲生大黄粉防治重型颅脑损伤后消化道并发症的临床研究

目的 研究重型颅脑损伤后早期鼻饲生大黄粉防治消化道并发症、促进消化道功能恢复的作用。方法 选择GCS3～8分重型颅脑损伤患者37例作为观察组，入院24h后鼻饲生大黄粉0．1g／kg，3次／d，并与同期未予生大黄粉的35例患者作对照（所有患者其他治疗措施均相同）。比较两组患者给药后3d、5d胃液潴留量与上消化道出血发生率和开始肠内营养供给时间。结果 观察组治疗后3d、5d胃液潴留量明显较治疗前和对照组减少（P〈0．05）；上消化道出血发生率也较对照组明显下降（P〈0．05）；观察组开始肠内营养供给的时间较对照组明显缩短（P〈0．05）。结论 重型颅脑损伤后早期鼻饲生大黄粉能有效减少胃液潴留量和上消化道出血发生率，有助于早期开始肠内营养供给，从而提高救治的成功率。

Prevention of gastrointestinal complications after severe brain injuries by early nasogastric feeding of rhubarb powder

Objective To observe the efficacy of early nasogastric feeding of rhubarb powder in prevention of gastrointestinal complications after severe brain injuries. Methods Thirty seven patients with severe brain injuries (Glasgow coma scale score of 8 or less on admission) received rhubarb powder feeding (0.1g/kg, tid ) 24 hours after admission (trial group). The control group was treated as trial group but without rhubarb powder. Results The gastric fluid residual volumes after 3 and 5 days after rhubarb feeding in trial group were less than those before feeding and those in control group(P<0.05). The incidence of upper gastrointestinal bleeding in trial group was lower than that in control group(P<0.05).The time of gastrointestinal function restoration in trial group was shorter than that in control group(P<0.05). Conclusion Early nasogastric feeding with rhubarb powder can reduce the gastric fluid residual volumes and the incidence of upper gastrointestinal bleeding.