机构地区:[1]Sehan University,Mokpo,Republic of Korea58447 [2]延边大学附属医院,吉林延吉133099
出 处:《中西医结合护理》2023年第7期209-214,共6页Chinese Journal of Integrative Nursing
摘 要:目的探究经鼻肠管肠内营养支持联合快速康复外科理念(FTS)对重症颅脑损伤患者营养状况、并发症及术后恢复的影响。方法回顾性分析2019年6月—12月医院收治的100例SHI患者的临床资料,按治疗方式的不同分为对照组(n=58)和观察组(n=42)。两组均采取基于FTS的干预措施,其中对照组行常规经鼻胃管肠内营养支持,观察组行经鼻肠管肠内营养支持。比较两组治疗前后营养状况[血清总蛋白(TP)、前白蛋白(PAB)、血红蛋白(Hb)]、肠黏膜屏障功能[血清肠型脂肪酸结合蛋白(Ⅰ-FABP)、血浆D-乳酸(D-LA)]、炎症因子[白细胞介素-6(IL-6)、超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]及并发症、术后恢复[运动功能Fugl-Meyer运动功能评定量表(FMA)、简易精神状态评价量表(MMSE)、格拉斯哥预后量表(GOS)]情况。结果与对照组相比,观察组治疗后TP、PAB、Hb水平更高,Ⅰ-FABP、D-LA水平及血清IL-6、hs-CRP、TNF-α水平更低,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组(19.05%vs 37.93%,P<0.05)。观察组治疗后FMA、MMSE评分高于对照组(P<0.05),且观察组治疗后GOS评分等级较对照组更优(P<0.05)。结论经鼻肠管营养支持联合FTS可有效改善SHI患者营养状况、肠黏膜屏障功能,抑制炎症反应,进而降低并发症发生率,提高术后恢复质量。Objective To investigate the influence of enteral nutrition support via nasointestinal tube combined with fast-truck surgery on nutritional status,complications and postoperative rehabilitation of patients with severe head injury.Methods Totally 100 patients with severe head injury were divided into the control group(n=58)and the observation group(n=42)according to the nutrition support methods.All patients received nursing interventions based on the theory of fast-truck surgery.Patients in the control group received enteral nutrition by nasogastric tube,and those in the observation group were given enteral nutrition by nasointestinal tube.The nutritional status[serum total protein(TP),prealbumin(PAB)、hemoglobin(Hb)],intestinal mucosal barrier function[intestinal fatty acid-binding protein(I-FABP),plasma D-lactic acid(D-LA)],in-flammatory factor[interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor ne-crosis factor-α(TNF-α)],postoperative complication,postoperative rehabilitation[Fugl-meyer Motor Function Rating Scale(FMA),The Mini-Mental State Examination(MMSE),Glasgow Outcome Scale(GOS)]of patients were measured and compared between two groups.Results Patients in the observation group had higher levels of TP,PAB,Hb and lower levels ofⅠ-FABP,D-LA,IL-6,hs-CRP,TNF-αcompared with those in the control group after treatment(P<0.05).The incidence of complications in the observation group was lower than that in the con-trol group(19.05%vs.37.93%,P<0.05).Scores of FMA and MMSE in the observation group were higher than those in the control group(P<0.05).A better outcome of GOS in the observation group was reported compared with that in the control group(P<0.05).Conclusion The en-teral nutrition support via nasointestinal tube combined with fast-truck surgery is potentially effective to improve the nutritional status and intestinal mucosal barrier function,reduce the inflamma-tory response and postoperative complications,improve the postoperative rehabilitation and quali-ty of life among patients with
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