肠内营养改善重型颅脑损伤患者应激性溃疡的临床研究  

Reduction of stress ulcer in patients with severe craniocerebral injury by enteral nutrition: a clinical study

作　　者：程新富[1] 张志强[1] 陈红庆[1] 刘宗霖[1] 谭宗德[1] 程坤[1] 

机构地区：[1]解放军161医院神经外科,武汉430010

出　　处：《西南国防医药》2013年第6期595-597,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨重型颅脑损伤患者早期足热量肠内营养临床应用价值。方法重型颅脑损伤患者共129例,随机分为治疗组(86例)和对照组(43例),治疗组早期(伤后24 h内)给予足热量肠内营养,对照组给予静脉营养,所有患者伤后2 w内行胃液和大便隐血实验,比较两组患者应激性溃疡发生率;随访存活患者,行GOS评分,比较两组患者GOS评分差异。结果治疗组应激性溃疡发生15例(17.4%),对照组应激性溃疡发生15例(34.9%),两组间应激性溃疡发生率有统计学差异(P<0.05);两组存活患者GOS评分亦有统计学差异(P<0.01)。结论早期(伤后24 h内)足热量肠内营养可有效降低重型颅脑损伤患者应激性溃疡的发生率,明显改善患者预后。Objective To evaluate the clinical application value of early enteral nutrition（EN） with full caloric replacement in patients with severe craniocerebral injury.Methods 129 cases of severe craniocerebral injury were randomly divided into 2 groups,i.e.treatment group（86 cases） and control group（43 cases）.The treatment group received EN with full caloric replacement within 24 hours after the injury,and the control group received parenteral nutrition.All the patients underwent gastric juice and fecal occult-blood test within two weeks after the injury.Comparison was made in the incidence of stress ulcer between the two groups.Follow-up and GOS scoring were carried out among the survivors,and the scores were compared between the tow groups.Results Stress ulcer occurred in 15 cases of the treatment group（17.4%） and in 15 ones of the control group（34.9%）,and there were significant differences between the two groups（P 0.05）.There were also significant differences in the GOS scores between the two groups（P 0.01）.Conclusion Full caloric EN within 24 hours after the injury can effectively decrease the incidence of stress ulcer in patients with severe craniocerebral injury and obviously improve the prognosis.

关 键 词：颅脑损伤 肠内营养 应激性溃疡 

分 类 号：R651.15[医药卫生—外科学]