经鼻营养支持对急性颅脑损伤后机体蛋白质代谢的影响  

The Effects of Nasal Nutrition on Protein Metabolism in the Body after Acute Brain Injury

作　　者：朱永华[1] 林少华[1] 黄汉添[1] 廖巍[1] 胡子慧[1] 李亮明[1] 林其昌[1] 林伟标[1] 郑文健[1] 

机构地区：[1]中山市人民医院神经外科,广东中山528400

出　　处：《医学综述》2016年第13期2624-2626,共3页Medical Recapitulate

摘　　要：目的探讨经鼻营养支持对急性颅脑损伤后机体蛋白质代谢的影响。方法选取2013年7月至2015年7月中山市人民医院接诊的急性颅脑损伤患者300例。按随机数字表法分为对照组和观察组,各150例。观察组采用经鼻营养支持治疗,对照组采用常规静脉营养支持治疗。观察两组患者治疗前后胰岛素用量和血糖控制情况、治疗前后营养情况、胃肠道功能障碍情况、并发症发生率及临床疗效。结果治疗后,观察组胰岛素用量、空腹血糖、血糖达标时间均小于对照组[(31±9)U/d比(41±15)U/d,(5.2±1.3)mmol/L比(6.9±1.7)mmol/L,(6.4±1.2)d比(9.6±3.2)d]差异有统计学意义(P<0.01);观察组前白蛋白、血红蛋白、球蛋白均显著高于对照组[(227±48)mg/L比(188±41)mg/L,(112±17)g/L比(105±15)g/L,(25±4)g/L比(17±4)g/L],差异有统计学意义(P<0.01);观察组临床总有效率显著高于对照组[80.00%(120/150)比45.33%(68/150)](P<0.05);观察组胃肠道功能障碍总发生率显著低于观察组[35.33%(53/150)比78.00%(117/150)],差异有统计学意义(P<0.01);观察组并发症总发生率显著低于对照组[25.33%(38/150)比51.33%(77/150)],差异有统计学意义(P<0.01)。结论经鼻营养支持可以维持急性颅脑损伤后机体营养状况,蛋白质的流失可以得到有效的改善,代谢功能也能恢复正常,值得临床推广。Objective To investigate the effect of nasal nutrition support on protein metabolism in the body after acute brain injury. Methods Total of 300 patients with acute craniocerebral injury in Zhongshan People＇s Hospital from Jul. 2013 to Jul. 2015 were included in the study. Random number table method was used to divide the patients into a control group and an observation group, 150 cases each. The observation group received nasal nutritional support treatment, and the control group received conventional parenteral nutrition support. The insulin dosage and glycemic control, nutrition situation, gastrointestinal dysfunction, the complication rate and clinical efficacy before and after treatment of the two groups were observed. Results After treatment, the insulin dosage, fasting blood glucose and blood glucose reaching standard time of the observation group were less than the control group [ （31 ± 9 ） U/d vs （41 ±15 ） U/d, （5.2 ± 1.3 ） mmol/L vs （6.9 ±1.7 ） mmol/L, （6. 4 ± 1.2 ） d vs （ 9. 6 ± 3.2 ） d ], the differences were statistically significant （P 〈0. 01 ） ;the serum albumin,hemoglobin and globulin in the observation group were significantly higher than the control group[ （227 ±48） mg/L vs （188 ±41） mg/L,（112 ±17） g/L vs （105 ±15） g/L,（25± 4） g/L vs （ 17 ±4） g/L] ,the differences were statistically significant（P 〈0.01 ）. The total effective rate of the observation group was significantly higher than the control group [ 80. 00% （120/150） vs 45.33% （ 68/ 150） ] （ P 〈 0. 05 ） ; The total incidence of gastrointestinal dysfunction in the observation group was significantly lower than the observation group[ 35.33% （53/150） vs 78.00% （117/150）] ,the difference was statistically significant（ P 〈 0. 01 ）; The incidence of complications in the observation group was significantly lower than the control group[25.33% （38/150） vs 51.33% （77/150） ] ,the difference was statistically significant（P 〈0.01 ）. Conclus

关 键 词：颅脑损伤 经鼻营养 蛋白质代谢 

分 类 号：R651.15[医药卫生—外科学]