特重型颅脑损伤肠外肠内的序贯营养支持  

Sequent use of total parenteral nutrition and enteral nutrition in patients with specially serious celebral injuries

作　　者：张建军[1] 顾水均[1] 宣宏飞[1] 谢仁龙[1] 张俊[1] 来谊[1] 

机构地区：[1]萧山市第一人民医院神经外科

出　　处：《肠外与肠内营养》1999年第2期82-84,共3页Parenteral & Enteral Nutrition

基　　金：萧山市科协科研基金

摘　　要：目的：探讨特重型颅脑损伤早期全肠外（ＴＰＮ）营养逐步过渡为肠内营养支持的临床意义及合理性。方法：营养组：１７例ＧＣＳ≤５分特重型颅脑损伤病人伤后２天开始应用ＴＰＮ，６～７天后根据病情逐渐给予部分肠内营养（ＥＮ）过渡，１０天后改为完全的ＥＮ。观察血糖、白蛋白、淋巴细胞计数、并发症发生率及预后。对照组：常规治疗的２０例特重型颅脑损伤作对照。结果：特重型颅脑损伤病人能从早期的ＴＰＮ中获得较充分的能量和蛋白质合成物，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优于对照组（Ｐ＜０．０５）。１周后逐渐过渡至ＥＮ更符合机体的生理要求，能保护肠粘膜屏障，使并发症减少。营养组１周后死亡率为２９％，明显低于对照组（６５％）（Ｐ＜０．０５）。结论：肠外、肠内序贯营养支持符合特重型颅脑损伤病人的病理、生理要求，能使该类病人营养状况和生存率提高。Objectives:To investigate the clinical significance of sequent use of total parenteral nutrition(TPN) and enteral nutrition(EN) in patients with specially serious celebral injuries. Methods:17 cases of specially serious celebral injuries with GCS≤5 were given TPN for about one week and gradually changed to EN.Blood glucose,albumin,peripheral blood lymphocyte count,complication and outcome were observed.20 cases of specially serious celebral injuries who had been treated traditionally were regarded as control. Results:Blood glucose,albumin,total number of peripheral blood lymphocyteell count in parenteral nutrition support group by one week were significantly better than those in control group( P <0.05).Complication rate and mortality in nutritional support group was 26 percent,significantly lower than those in control group. Conclusions:Sequent nutritional support can decrease complication rate and increase survival rate in patients with specially serious celebral injury.

关 键 词：特重型 颅脑损伤 序贯营养支持 

分 类 号：R651.150.5[医药卫生—外科学] R459.3[医药卫生—临床医学]