早期肠内营养对重型颅脑损伤患者血清C反应蛋白含量变化的影响  

Effect of Early Enteral Nutrition on C Reactive Protein Contents in Serum of Patients with Severe Craniocerebral Injury

作　　者：齐洪武[1] 孙为民[2] 王政刚[1] 张旭东[1] 樊丰势[1] 张卫宁[1] 程建业[1] 

机构地区：[1]中国人民解放军白求恩国际和平医院神经外科,河北石家庄050082 [2]河北医科大学附属第三医院神经外科,河北石家庄050051

出　　处：《中国临床神经外科杂志》2009年第4期213-216,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的观察早期肠内营养(EEN)对重型颅脑损伤患者血清C反应蛋白(CRP)的影响,探讨EEN对保护肠道黏膜、减轻全身炎症反应的作用。方法30例重型颅脑损伤患者中,GCS6～8分者23例,GCS3～5分者7例。随机分为EEN组(15例)和早期胃肠外营养(PN)组(15例)。入院48h内给予不同方法的营养支持。测定入院时及伤后1、4、7和14d血浆中CRP的含量。结果随着伤后时间推移两组患者血清CRP浓度均呈下降趋势,但EEN组下降幅度更明显,伤后第4、7及14天EEN组血清CRP含量明显低于PN组(P<0.05或P<0.01)。EEN组伤后14dGCS评分明显高于PN组(P<0.05)。结论EEN可保护重型颅脑损伤患者的胃肠道黏膜,减轻其全身炎症反应,改善其意识状态。如果重型颅脑损伤患者胃肠道功能允许,应尽早给予EEN。Objective To observe the effect of early enteral nutrition （EEN） on C reactive protein （CRP） content in the serum in order to explore the effect of EEN on enteral mucous membrane and systemic inflammatory reaction in the patient with severe craniocerebral injury. Methods Thirty patients with severe craniocerebral injury （GCS〈8）, including 23 patients with GCS 6-8 and 7 patients with GCS 3-5, were randomly divided into two groups, i.e. EEN group （15 cases） and early parenteral nutrition （PN） group （15 cases）. The nutrition support was given to all the patients within 48 hours after admission to the hospital. The serum CRP concentrations in all the patients were determined immediately, 1 day, 4 days, 7 days and 14 days respectively after the injury. Results The serum CRP concentrations in both the groups were gradually decrease as time went on after the injury. The serum CRP concentrations were significantly lower in the EEN group 4, 7 and 14 days after the injury than those in PN group （P〈0.05 or P〈0.01）. GCS was significantly higher in EEN group 14 days after the injury than that in PN group （P〈0.05）. Conclusion EEN can protect the mucous membrane of the gastro-intestinal tracts and reduce systemic inflammatory reaction in the patients with severe craniocerebral injury. If the gastro-intestinal tract function permits, EEN should be performed in the patients with severe craniocerebral injury.

关 键 词：早期肠内营养 重型颅脑损伤 C反应蛋白 肠外营养 

分 类 号：R651.15[医药卫生—外科学] R459.2[医药卫生—临床医学]