电针对重型颅脑损伤患者肠内营养实施的效果观察  

Effect of electroacupuncture on implementation of enteral nutrition in patients with severe craniocerebral injury

作　　者：葛丹霞 吴力 吴燕 马桂芝 张庚[3] 赖志珍[3] 

机构地区：[1]宁波市中医院重症医学科,浙江宁波315010 [2]宁波市中医院针灸推拿科,浙江宁波315010 [3]浙江省立同德医院,浙江杭州310012

出　　处：《中国中西医结合急救杂志》2017年第6期633-636,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医药科技计划项目（ZA21619）

摘　　要：目的 观察电针对重型颅脑损伤患者早期肠内营养（EEN）支持的影响.方法 采用前瞻性随机对照研究方法,选择2014年1月至2016年10月宁波市中医院重症医学科（ICU）收治的50例重型颅脑损伤患者,按随机数字表法将患者分为电针试验组26例和常规治疗对照组24例.患者入院24~48 h均实行肠内营养（EN）支持,电针试验组从入院第1天即给予电针刺激穴位,每日1次、每次30 min,连续10 d.记录两组患者治疗3 d和5 d EN热量达标情况和需加用肠外营养（PN）支持情况以及鼻饲1、4、7 d喂养量;观察两组患者EN支持期间并发症发生率.结果 治疗5 d电针试验组EN支持热量达标比例明显高于常规治疗对照组 〔92.3%（24/26）比70.8%（17/24）〕.治疗3 d和5 d电针试验组需加用PN的比例均低于常规治疗对照组 〔3 d：19.2%（5/26）比25.0%（6/24）,5 d：7.7%（2/26）比16.7%（4/24）〕,但两组比较差异均无统计学意义（均P〉0.05）.治疗4 d和7 d电针试验组喂养量明显高于常规治疗对照组〔4 d（mL）：1292.31±123.04比1204.17±139.81,7 d（mL）：1342.31±113.75比1275.00±103.21,均P〈0.05〕.EN支持10 d内,电针试验组并发症发生率明显低于常规治疗对照组〔26.92%（7/26）比41.67%（10/24）,P〈0.05〕.结论 电针对重型颅脑损伤患者EN支持的实施具有一定临床价值,早期电针干预能有效改善患者胃肠功能,提高EN达标率,且电针疗法简便、有效、安全,无明显不良反应.Objective To observe the effect of electroacupuncture on early enteral nutrition （EEN） support in patients with severe craniocerebral injury.Methods A prospective, randomized, controlled study was conducted, 50 patients with severe craniocerebral injury admitted to the the Department of Intensive Care Unit of Traditional Chinese Medicine Hospital of Ningbo from January 2014 to October 2016 were enrolled, and they were randomly divided into electroacupuncture experimental group （26 cases） and conventional treatment control group （24 cases） by randome number table. Enteral nutrition （EN） support was implemented in 24 - 48 hours after admission for all the patients, additionally, the electroacupuncture experimental group was treated by electroacupuncture stimulating acupoint from the 1st day after admission, once 30 minutes daily for consecutive 10 days. The levels of EN calorie reaching standard situation and the parenteral nutrition （PN） necessary for addition were recorded on 3 days and 5 days after admission; the nasal feeding amount of the two groups was recorded on the 1, 4, 7 days; the incidences of complications during EN support period were observed in both groups.Results The proportion of EN calorie reaching the standard in electroacupuncture experimental group was significantly higher than that in the conventional treatment control group in 5 days of treatment [92.3% （24/26） vs. 70.8% （17/24）,P 〈 0.05]. The proportions necessary for addition of PN support were lower in electroacupuncture experimental group than those in the conventional treatment control group on 3 days and 5 days of treatment [3 days： 19.2% （5/26） vs. 25.0% （6/24）, 5 days： 7.7% （2/26） vs. 16.7% （4/24）], but there were no significant statistical differences between the two groups （bothP 〉 0.05）. The nasal feeding amounts in electroacupuncture experimental group were significantly higher than those in the conventional treatment control group on 4 days and 7 days of treatment [4 days �

关 键 词：电针 颅脑损伤 重型 肠内营养支持 

分 类 号：R684[医药卫生—骨科学]