早期肠内肠外营养支持对脑出血术后患者营养状况的影响  

Effects of Early Enteral and Parenteral Nutrition Support on Nutritional Status in Patients with Cerebral Hemorrhage

作　　者：童欣[1] 贾凯[1] 梁芳[2] 

机构地区：[1]首都医科大学附属北京朝阳医院营养科,北京100020 [2]首都医科大学附属北京朝阳医院高压氧科,北京100020

出　　处：《中国食物与营养》2015年第6期72-75,共4页Food and Nutrition in China

摘　　要：目的:比较脑出血患者术后肠外营养与肠内营养支持的营养支持效果。方法:将高压氧科脑出血患者分为肠外营养(PN)组、肠内营养医用制剂(EN1)组、肠内营养医用食品(EN2)组,比较3组患者营养支持治疗3w后血清白蛋白(ALB)、甘油三酯(TG)及CD3+、CD4+等免疫生化指标,观察恶心、呕吐与腹泻等消化道症状,并测量AMC、TSF值。结果:3组生化指标ALB、TG、CD3+、CD4+等指标治疗前比较无明显差异(P>0.05),营养支持后比较,PN组血清ALB水平最低,EN2组血清ALB水平最高,差异具有显著性意义(P<0.05);PN组血清TG水平较EN1、EN2组明显增高,差异具有显著性意义(P<0.01)。EN2组CD3+、CD4+较PN及EN1组明显升高差异具有显著性意义(P<0.05)。EN组平均住院时间、治疗费用明显低于PN组,EN2组低于EN1组,3组间差异具有显著统计学意义。结论:使用肠内营养制剂虽无改善脑出血术后患者的远期疗效的明确依据,但可在急性期治疗中减少并发症及住院时间、降低治疗总费用。与肠外营养相比,早期肠内营养支持可较好地改善患者营养状况。Objective To compare effects of parenteral and enteral nutrition support on nutritional status in patients with cerebral hemorrhage. Method The patients with cerebral hemorrhage in Hyperbaric Oxygen Department of Beijing Chaoyang Hospital were divided into parenteral nutrition group（ PN）,enteral nutrition group1（ EN1） and enteral nutrition group 2（ EN2）. Serum albumin,triglyceride,and CD3 ＋,CD4 ＋ and other immune and biochemical indicators among the three groups of patients after nutritional support treatment for3 weeks were compared. Nausea,diarrhea and other digestive trace symptoms,and AMC,TSF were also observed. Result Before the treatment,biochemical indicators including ALB,TG,CD3,CD4 among three groups were not significant. After the nutrition support,ALB level in the PN group was the lowest,and ALB level in EN2 group was the highest. TG level in PN group was higher compared with EN1 and EN2 group. Percentage levels of CD3 and CD4 in EN2 increased significantly. The cost in EN2 group were much cheaper than those in EN1 group and EN2 group. Conclusion Compared with parenteral nutrition support,early enteral nutrition support could improve the nutritional status of patients with cerebral hemorrhage and reduce complications.

关 键 词：脑出血 营养支持 肠内营养 肠外营养 

分 类 号：R651.1[医药卫生—外科学] R459.3[医药卫生—临床医学]