经鼻胃管早期规范化肠内营养对颅脑损伤患者的影响

发布时间：2018-05-21 03:34

本文选题：肠内营养 + 肠外营养　；参考：《广东医学》2016年06期

【摘要】：目的探讨经鼻胃管早期规范化肠内营养对颅脑损伤患者的影响。方法 120例颅脑损伤患者随机分为肠内营养组与肠外营养组各60例,在手术治疗基础上,肠外营养组在入院12 h内给予全肠外营养治疗,肠内营养组在入院12 h内给予全肠内营养治疗,观察患者近远期预后情况。结果两组营养支持第3天的血清白蛋白和前白蛋白含量均明显低于营养支持第1天(P0.05);同时肠内营养组营养支持第7天的血清白蛋白和前白蛋白含量明显高于营养支持第3天,也都明显高于肠外营养组(P0.05)。两组营养支持第3天的淋巴细胞计数明显低于营养支持第1天,C反应蛋白明显高于营养支持第1天(P0.05);同时肠内营养组营养支持第7天的淋巴细胞计数和C反应蛋白与营养支持第3天和肠外营养组比较差异均有统计学意义(P0.05)。肠内营养组与肠外营养组营养支持7 d内腹泻、消化道出血、吸入性肺炎、反流等并发症总体发生率分别为10.0%和31.7%,差异有统计学意义(P0.05)。所有患者均进行电话随访6个月,经过调查,肠内营养组伤后3个月与6个月的病死率分别为1.7%和5.0%,而肠外营养组分别为10.0%和16.7%,肠内营养组的远期病死率明显低于肠外营养组(P0.05)。结论经鼻胃管早期规范化肠内营养在颅脑损伤患者中的应用能能改善机体内营养状况,提高机体免疫功能,降低炎症因子的表达,减少并发症的发生,从而减少其总体远期死亡。
[Abstract]:Objective to investigate the effect of early standardized enteral nutrition through nasogastric tube on patients with craniocerebral injury. Methods 120 patients with craniocerebral injury were randomly divided into enteral nutrition group (n = 60) and parenteral nutrition group (n = 60). Enteral nutrition group was treated with total enteral nutrition within 12 hours after admission. Results the levels of serum albumin and prealbumin in the two groups were significantly lower than those in the first day of nutrition support (P 0.05), while the contents of serum albumin and prealbumin in the enteral nutrition group on the 7th day were significantly higher than those in the third day of nutrition support. It was also significantly higher than that of parenteral nutrition group (P 0.05). The lymphocyte count on the 3rd day of nutrition support in both groups was significantly lower than that on the first day of nutrition support, and the number of lymphocytes and C-reactive eggs on the 7th day of nutrition support in enteral nutrition group was significantly higher than that in the first day of nutrition support. There were significant differences between white group and nutrition support group on the 3rd day and parenteral nutrition group (P 0.05). The overall incidence of diarrhea, gastrointestinal hemorrhage, aspiration pneumonia and reflux in enteral nutrition group and parenteral nutrition group were 10.0% and 31.7%, respectively. The difference was statistically significant (P 0.05). All the patients were followed up by telephone for 6 months. The mortality of enteral nutrition group was 1.7% and 5.0% at 3 and 6 months after injury, while that of parenteral nutrition group was 10.0% and 16.7m respectively. The long-term mortality of enteral nutrition group was significantly lower than that of parenteral nutrition group (P 0.05). Conclusion the application of early standardized enteral nutrition through nasogastric tube in patients with craniocerebral injury can improve the nutritional status of the body, improve the immune function, reduce the expression of inflammatory factors, and reduce the incidence of complications. Thus reducing its overall long-term death.
【作者单位】：湖北省黄冈市中心医院神经外科;湖北医药学院;
【基金】：湖北省教育厅基金项目(编号:B2013121)
【分类号】：R651.15

【相似文献】