肠内加肠外营养对重症颅脑损伤患者营养状态及免疫功能的影响  

Effects of enteral and parenteral nutrition on nutritional status and immune function of patients with severe traumatic brain injury

作　　者：徐文婷[1] 王银玲 李静[1] 廖广园[1] 高元妹[1] XU Wenting;WANG Yinling;LI Jing;LIAO Guangyuan;GAO Yuanmei(Department of Critical Care Medicine,the Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510000)

机构地区：[1]广州医科大学附属第三医院重症医学科

出　　处：《郑州大学学报（医学版）》2019年第5期708-711,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：广东省自然科学基金项目(2017A030313857)

摘　　要：目的:探究肠内加肠外营养对重症颅脑损伤患者营养状态及免疫功能的影响。方法:86例重症颅脑损伤患者中43例给予肠内营养(对照组),43例给予肠内加肠外营养(观察组)。比较2组治疗前后营养状态、免疫功能、血流动力学和不良反应发生率。结果:治疗后,两组血清总蛋白、血清白蛋白、前白蛋白和血红蛋白及免疫球蛋白(IgA、IgM和IgG)含量均呈升高趋势,且观察组优于对照组(P<0.05);两组治疗后血流速度均逐渐提升,搏动指数逐渐降低,且观察组优于对照组(P<0.05)。两组均出现电解质紊乱、呕吐、反流和肝胆功能异常等不良反应,但不良反应发生率差异无统计学意义(P>0.05)。结论:肠内加肠外营养能提供重症颅脑损伤患者所需营养,提高患者免疫功能且不产生严重不良反应。Aim:To explore the effects of enteral and parenteral nutrition on nutritional status and immune function of patients with severe traumatic brain injury(TBI).Methods:A total of 86 patients with severe TBI were allocated into control group and observation group.The patients in control group were given traditional nasogastric tube nutrition(enteral nutrition),and observation group was given enteral and parenteral nutrition support.The changes of nutritional status,immune function,hemodynamics and incidence rate of adverse reactions were compared before and after treatment.Results:After treatment,the levels of serum total protein,serum albumin,serum prealbumin,hemoglobin and immunoglobulins(IgA,IgM and IgG)in the two groups were increased gradually,and the above indexes in the observation group were improved more greatly(P<0.05).After treatment,the blood flow velocity in the two groups was gradually increased while the pulsation index was decreased gradually,which were superior in the observation group(P<0.05).Adverse reactions of electrolyte disturbance,vomiting,reflux and abnormal liver and gallbladder function occurred in both groups,and there were no significant difference in incidence of adverse reactions between the 2 groups(P>0.05).Conclusions:Enteral and parenteral nutrition could provide the nutrition needed for patients with severe TBI,and improve the immune function without severe adverse reactions.

关 键 词：肠内加肠外营养 重症颅脑损伤 营养状态 免疫功能 

分 类 号：R651.1[医药卫生—外科学]