早期肠内营养与肠外营养在重症外伤性脑损伤治疗中的应用比较  

A comparison between enteral nutrition and parenteral nutrition support used in the patients with severe traumatic brain injury at early treatment stage

作　　者：陈锐[1] 张高炼[1] 张晓宁[1] 

机构地区：[1]广西中医药大学第一附属医院神经内科,广西南宁530000

出　　处：《实用医药杂志》2016年第11期973-976,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨早期肠内营养与肠外营养支持在重症外伤性脑损伤患者治疗中的合理应用。方法将93例患者随机分为治疗组和对照组,治疗组53例早期通过胃管滴注肠内营养,对照组40例按传统方法早期静脉滴注肠外营养,期间检测血生化、血常规指标、炎症指标,并观察在治疗中并发症发生情况、格拉斯哥昏迷指数(GCS评分)、重度致残率及出院时格拉斯哥预后评分(GOS评分)。结果早期给予胃肠道营养支持的治疗组患者,在血红蛋白浓度、重度致残率、并发症发生情况方面与对照组无统计学差异(P>0.05),但是治疗组患者在人血白蛋白、GCS评分、C反应蛋白浓度及出院GOS评分方面优于对照组,结果有统计学意义(P<0.05)。结论对于重症外伤性脑损伤患者,早期肠内营养支持经济、有效,符合生理结构,能更好地维持机体的营养状况,明显降低炎症指标和减少患者并发症的发生,从而改善患者的营养状态和预后。Objective To explore the reasonable application of early enteral nutrition and parenteral nutrition support in the patients with severe traumatic brain injury at treatment stage. Methods The 93 patients were randomly divided into treatment group and control group,in treatment group 53 cases were supported enteral nutrition through stomach tube at early stage,while control group 40 cases parenteral nutrition throuth intravenous injection according to the tradition. During the trial the detection of blood biochemistry,blood routine index,inflammation index were made,and the complications after the treatment were observed,the Glasgow coma scale（GCS score）,severe disable morbidity and Glasgow outcome score（GOS score） were assessed when discharged from hospital. Results The patients in treatment group with early gastrointestinal nutrition support in hemoglobin concentration,severe disable morbidity,complications occurrence had no significant difference compared with the control group（P〉0.05）,but in serum albumin,GCS score,C-reactive protein concentration and GOS score when discharged in treatment group was better than that in control group（P〈0.05）. Conclusion For the patients with severe traumatic brain injury,enteral nutrition support at early stage is economic,effective and conform to the physiological structure,better to maintain the body＇s nutritional status,significantly reduce inflammation index and reduce complications,thus can improve the nutritional status and prognosis of patients.

关 键 词：重症外伤性脑损伤 肠外营养 肠内营养 

分 类 号：R651.15[医药卫生—外科学]