肠内营养时机对老年重型颅脑疾病术后临床疗效的影响  

Effects of Enteral Nutrition on Clinical Curative Effect in Elderly Patients with Severe Craniocerebral Diseases

作　　者：刘瑞东[1] 周忆频[1] 

机构地区：[1]天津市第三中心医院神经外科,300170

出　　处：《天津医药》2014年第11期1106-1109,共4页Tianjin Medical Journal

摘　　要：目的：研究老年重型颅脑疾病术后开始建立肠内营养的最佳时机。方法将81例老年重型颅脑疾病患者分为A、B、C组，分别于手术后24 h、25-48 h、49-72 h开始建立肠内营养支持，分别监测血清生化指标、并发症和GCS评分的变化。结果术后血清生化指标变化：B组血清白蛋白及血红蛋白水平较A、C组增高，A、B组淋巴细胞总数较C组明显增高（P＜0.05）。并发症方面：术后7 d，B组腹泻发生比例少于A组（3.6%vs 26.9%），应激性溃疡比例少于C组（0 vs 22.2%）；术后14 d，B组肺感染发生比例少于A组（10.7%vs 38.5%），应激性溃疡比例少于C组（3.6%vs 25.9%）。术后14 d，B组GCS评分高于A、C组（10.2±1.3 vs 9.5±1.2 vs 9.4±1.2,P＜0.05）。结论对老年重型颅脑疾病患者于手术后25-48 h内开始给予肠内营养更能满足营养及代谢支持的需要，减少并发症，有利于患者意识水平的恢复。Objective To investigate the best time to establish the enteral nutrition （EN） in elderly patients with severe craniocerebral diseases. Methods Eighty-one elderly patients were divided into groups A, B and C. The EN support were given 24 h, 25-48 h, and 49-72 h after surgery. Changes of serum biochemical indexes, complications and GCS score were detected and statistical analysed. Results The serum levels of albumin and hemoglobin were significantly increased in group B than those of group A and group C. The total number of lymphocytes was significantly higher in group A and group B than that of group C （P〈0.05）. The amount of diarrhea was significantly fewer 7-day after operation in group B than that of group A （3.6%vs 26.9%）. The amount of stress ulcer was significantly fewer in group B than that of group C （0 vs 22.2%）. The amounts of lung infections （10.7%vs 38.5%） and stress ulcer （3.6%vs 25.9%） were significantly fewer 14-day after operation in group B than those of group A. The scores of GCS were significantly higher 14-day after operation in group B than those of group A and group C （10.2±1.3 vs 9.5±1.2 vs 9.4±1.2, P〈0.05）. Conclusion The establishment of EN support 25 to 48 hours after surgery may meet the need of nutritional and metabolic support, reduce complications, be conducive to the consciousness recovery in elderly patients with severe craniocerebral diseases.

关 键 词：肠道营养 颅脑损伤 脑出血 老年人 

分 类 号：R459.3[医药卫生—治疗学] R742[医药卫生—临床医学]