营养支持治疗在重型颅脑损伤病人中的合理应用  

The appropriate application of nutrition therapy in patient with severe craniocerebral injury

作　　者：林恩[1] 许海雄[1] 李克民[1] 张志宏[1] 郭骅[1] 罗友章[1] 方旭生[1] 

机构地区：[1]广东省汕头市中心医院神经外科,广东汕头515031

出　　处：《海南医学》2005年第11期36-38,共3页Hainan Medical Journal

摘　　要：目的探讨重型颅脑损伤病人营养支持的方法及合理性。方法对30例重型颅脑损伤病人伤后即实施肠外营养(PN),发病后早期(48小时)开始应用肠内营养(EN),并逐渐加量,不足部分以肠外营养补充,应激期(伤后7天内)注意适当减少葡萄糖的供给。观察血糖,白蛋白,淋巴细胞计数,并发症发生率及预后。结果本组治愈27例,死亡3例;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未出现明显异常,肠内营养期间无严重腹泻,腹胀等并发症。结论重型颅脑损伤后进行合理营养支持对预后有重要的临床价值,早期即行营养支持,应激期适当减少葡萄糖的供给,可提高重型颅脑损伤病人的救治成功率,降低并发症和死亡率。Objective To investigate the sequent use of nutrition support in patient with severe cerebral injury. Methods Parenteral nutrition （PN） wasused in 30 case with severe craniocerebral injury after trauma. Enteral nutrition （EN） was used in early phase（48h）, Parenteral nutrition was adopted when EN was insufficient. Dose of glucose was limited at early period（7days after occurrence）. Blood glucose, albumin, peripheral blood lymphocyte count, complication and outcome were observed. Results 27 cases were cured and 3 cases died. Blood glucose, albumin, total number of peripheral blood lymphocyte, ell-count change by one week were no found. There was no complication such as severe diarrhea, belly bulge. Conclusions Available nutritional support to the patients with severe craniocerebral injury plays an important role in the improvement of their prognosis. Early nutrition Support can improve the rate of cure and reduce the complication and mortality.

关 键 词：重型颅脑损伤 肠外营养 肠内营养 

分 类 号：R651.15[医药卫生—外科学]