富含精氨酸肠内营养支持对重型颅脑损伤患者预后的影响  

Effect of arginine-rich enteral nutrition support on prognosis of patients with severe brain injury

作　　者：张海军[1] 

机构地区：[1]承德市中心医院神经外科,河北省承德市067000

出　　处：《世界华人消化杂志》2015年第32期5228-5232,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨富含精氨酸肠内营养支持对重型颅脑损伤患者预后的影响,为重型颅脑损伤患者提供科学有效的营养支持.方法:回顾性分析2014-07/2015-07承德市中心医院收治的重型颅脑损伤患者309例的临床资料,根据患者接受的术后肠内营养不同分为标准营养组(EN组)和精氨酸强化组(AEN组),主要评价两组患者术后7d的营养学指标、免疫学指标、术后并发症以及预后情况.结果:两组患者术前总蛋白含量、白蛋白含量、血红蛋白含量以及前白蛋白含量的差异均无统计学意义(P>0.05),干预7d后,两组患者的总蛋白含量的差异无统计学意义(P>0.05),AEN组患者的白蛋白含量、血红蛋白含量、前白蛋白含量均显著地高于EN.组,且差异具有统计学意义(P<0.05);两组患者白细胞含量与CD8^+比例的差异无统计学意义(P>0.05),AEN组总淋巴细胞含量、CD4^+含量、CD4^+/CD8^+比例均显著地高于EN组,且差异具有统计学意义(P<0.05);两组患者的伤口感染、呼吸道感染的差异无统计学意义(P>0.05),AEN组患者泌尿系统感染的比例以及术后并发症的总例数显著的低于EN组,且差异具有统计学意义(P<0.05),AEN组患者首次排便时间以及住院时间均显著的低于EN组,且差异具有统计学意义(P<0.05).结论:富含精氨酸肠内营养支持不仅可以有效改善重症颅脑损伤患者的营养指标和免疫功能,还可以有效地降低患者并发症的发生,缩短住院时间,值得临床推广.AIM：To investigate the effect of arginine-rich enteral nutrition support on the prognosis of patients with severe craniocerebral injury,and to provide scientific and effective nutritional support for patients with severe brain injury.METHODS：A retrospective analysis was performed of clinical data of 309 patients with severe craniocerebral injury treated from July2014 to July 2015 at our hospital.According to postoperative enteral nutrition the patients received,these patients were divided into a standard nutrition group（EN group） and an arginine enhanced group（AEN group）.On postoperative day 7,nutritional indicators,immunological indexes,postoperative complications and prognosis were compared between the two groups.RESULTS：Preoperative total protein content,albumin,hemoglobin and albumin levels showed no significant differences between the two groups（P 〉0.05）.On day 7 after intervention total protein content showed no statistical significance between the two groups（P〉 0.05）,but albumin,hemoglobin,and prealbumin levels were significantly higher in the AEN group than in the EN group（P〈0.05）.There were no significant differences in white blood cells or the proportion of CD8^＋ cells between the two groups（P〉 0.05）,but total lymphocyte content,proportion of CD4^＋ cells,and CD4^＋/ CD8^＋ ratio were significantly higher in the AEN group than in the EN group（P〈0.05）.There were no significant differences in the rates of wound infection or respiratory tract infection between the two groups（P〈0.05）,but the total number of cases of urinary tract infections and the proportion of postoperative complications were significantly lower in the AEN group than in the EN group（P〈0.05）.Time to first defecation and hospital stay were significantly shorter in the AEN group than in the EN group（P〈0.05）.CONCLUSION：Enteral nutritional support can not only effectively improve the nutritional status and immune function of patients with severe craniocerebral injury,but also

关 键 词：精氨酸 肠内营养 重型颅脑损伤 预后 

分 类 号：R651.15[医药卫生—外科学]