早期营养支持对重型颅脑损伤的临床意义  

The clinical significance of early nutritional support in severe head-injured patients

作　　者：张建军[1] 董伟峰[1] 朱镇宇[1] 

机构地区：[1]萧山市第一人民医院神经外科,浙江萧山311201

出　　处：《肠外与肠内营养》2001年第3期138-141,共4页Parenteral & Enteral Nutrition

摘　　要：目的 :评价不同营养方法对重型颅脑损伤早期营养支持的临床意义。　方法 :140例重型颅脑损伤者随机分成 5组 ,每组 2 8例。A组早期同时给予 EN和 PN ;B组给予早期 PN,1周后逐渐过渡至 EN ;C组单纯 PN ,PN时间超过 2周 ;D组早期给予单纯 EN;E组用传统的延迟性 EN。进行有关临床观察及统计学分析。　结果 :重型颅脑损伤者伤后早期能从不同营养途径获得营养成分。 A、B组 2周时血糖及各项营养指标均优于 D、E组 (P<0 .0 5 )与 C组基本相同 (P>0 .0 5 ) ,早、晚期并发症发生率低于其他 3组 ,预后优于其他 3组。 A、B两组间比较 ,A组消化道出血发生率低于 B组 ,费用更节约。　结论 :重型颅脑损伤后早期联合进行 EN、PN是临床较合理的营养支持方法 ,对预后有重要的价值。Objectives:To evaluate the clinical significance of different early nutrition support in severe head injured patients. Methods:140 cases(GCS≤8) were randomly divided into 5 groups.From A to E,each one had 28 cases.The patients in group A received early parenteral nutrition(PN) and enteral nutritoin(EN) together;group B received early PN,and EN after 1 week later;group C received PN only for more than 2 weeks;group D received early EN only;group E received traditional delayed EN.The clinical observation and statistical comparison were taken. Results:Severe head injured patients could get nutrition from different ways at early stage.A and B groups had better outcomes,and the blood glucose and nutritional data were superior to those of D,E group( P <0.05).The rate of complication and the prognosis of patients were better in group A or B than that of the other groups.Group A had lower rate of gastric hemorrhage than group B. Conclusions:Early nutritional support with PN and EN together is rational in the severe head injured patients,and helpful in improving prognosis of the patients.

关 键 词：颅脑损伤 重型 肠内营养 肠外营养 

分 类 号：R651.15[医药卫生—外科学]