不同鼻饲泵注方式对危重型颅脑损伤患者肠内营养及并发症的影响  

Effects of Different Nasal Feeding Methods on Enteral Nutrition and Complications in Patients with Severe Craniocerebral Injury

作　　者：黄丽萍[1] 陆玉萍[1] 吴雪燕[1] 徐玲[1] 

机构地区：[1]东南大学医学院附属江阴医院ICU室,江苏江阴214400

出　　处：《湖北民族学院学报（医学版）》2017年第2期41-43,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨不同鼻饲泵注方式对危重型颅脑损伤患者肠内营养及并发症的影响。方法 120例危重型颅脑损伤患者按照入院先后分为持续鼻饲组和间断鼻饲组,每组各60例,持续鼻饲组于术后第2 d9时持续泵注到第2d凌晨1时为止;间断鼻饲组于术后第2 d 9时开始,分8个单元,每个单元3 h,其中持续泵注2 h、暂停1 h,12 d后测定两组患者白蛋白、前蛋白和转铁蛋白水平,比较急性生理学与慢性健康状况(APACHE-Ⅱ)评分和胃肠道功能评分,比较两组患者并发症发生情况。结果鼻饲后两组血清蛋白指标比较差异不明显(P>0.05),鼻饲后两组APACH-ⅡE和胃肠道评分较鼻饲前均明显降低(P<0.05);组间比较,鼻饲后间断鼻饲组APACHE-Ⅱ和胃肠道评分均明显低于持续鼻饲组(P<0.05),持续鼻饲组胃潴留发生率25.00%(15/60),间断鼻饲组胃潴留发生率6.67%(4/60),两者比较差异明显(χ~2=8.352,P=0.004)。结论间断鼻饲泵注对重型颅脑损伤患者能有效降低APACHE-Ⅱ评分,促进胃肠道功能早日恢复,减少胃潴留的发生。Objective to study the effects of different nasal feeding methods on enteral nutrition and complications in patients with severe craniocerebral injury. Methods 120 cases with severe craniocerebral injury were divided into continuous nasal feeding group and intermittent nasal feeding group, 60 cases in each group. The continuous nasal feeding group received continuous infusion from 9：00 am and 1：00 am on day 2 after surgery. The intermittent nasal feeding group received infusion from 9：00 am on day 2 after surgery （a total of 8 units, 3 hours in each unit）, including continuous injection for 2 hours and pause for 1 hour. After 12days, the levels of albumin, prealbumin and transferrin were measured in the two groups. The acute physiology and chronic health conditions （APACHE- II） scores, gastrointestinal function scores and the complications were compared. Results After nasal feeding, the serum protein index in the two groups had no significant difference （P 〉 0.05） and the APACH - II E and gastrointestinal scores were significantly decreased before nasal feeding （P 〈 0.05）. The APACH - II E and gastrointestinal scores in the intermittent nasal feeding group were significantly lower than those in the continuous nasal feeding group （P 〈0.05）. The gastric retention rate was 25% （15/60） in the continuous nasal feeding group and 6.67%（4/60） in the intermittent nasal feeding group and the difference was significant（x2 = 8. 352 ,P = 0. 004）. Conclusion The intermittent nasal feeding can effectively reduce the APACHE - scores of patients with severe craniocerebral injury and the occurrence of gastric retention and promote the early recovery of gastrointestinal function.

关 键 词：危重型颅脑损伤 鼻饲 肠内营养 胃潴留 

分 类 号：R472.2[医药卫生—急诊医学]