重型颅脑损伤患者的代谢改变及营养支持

重型颅脑损伤以后 ,伤者代谢水平亢进 ,尤其是分解代谢明显增强 ,体内儿茶酚胺水平增高 ,引起血糖增高和低蛋白血症 ,同时静息能量消耗上升 ,出现急性期反应和细胞免疫功能下降等。这些异常改变都会影响伤者预后 ,所以应及时进行营养支持治疗 ,纠正代谢紊乱造成的不良后果。研究表明 ,营养治疗可以显著降低患者的病残率和死亡率

Metabolic abnormalities and nutritional support in patients with severe cranial-cerebral injuries

Patients with severe head injuries suffer a systemic metabolic response to hypermetabolism/hypercatabolism,hyperglycemia,acute phase response,and immune system alterations. The cause of these abnormalities is probably multifactorial. Of them,a high catecholamine levels is a main factor. Resting energy expenditure (REE) increases following closed head injury. These metabolic abnormalities will lead a poor prognosis,so nutritional management should be considered in the medical treatment of these patients. Several studies have proved that adequate nutritional support decreases mortality and morbidity.