营养支持治疗在神经外科危重病人中的合理应用  

The appropriate application of nutrition therapy in severe neurosurgical patients

作　　者：万海涛[1] 路红社[1] 平君[1] 杨中坚[1] 

机构地区：[1]第二军医大学利群临床教学院神经外科,上海200333

出　　处：《肠外与肠内营养》2003年第3期141-143,共3页Parenteral & Enteral Nutrition

摘　　要：目的 :探讨神经外科危重病人营养支持的方法。　方法 :对 2 8例神经外科危重病人早期 (发病后 4 8～ 72h)即开始实施肠内营养 ,并逐渐加量 ,不足部分以肠外营养补充 ;应激期 (发病后 7天内 )注意适当减少葡萄糖的供给。　结果 :本组治愈 2 3例 ,死亡 5例 ;治疗过程中未出现明显的糖、脂代谢异常和肝酶谱变化的代谢性并发症。肠内营养期间无严重腹泻、腹胀等并发症。使用呼吸机支持者均一次脱机成功 ,　结论 :早期即行肠内营养 ,逐渐过渡到完全肠内营养 ;应激期适当减少葡萄糖的供给 ,可提高脑外科危重病人的救治成功率 。Objectives:To investigate the nutrition support in patients with severe neurosurgical disease. Methods:Enteral nutrition(EN) was used in early phase(48～72 h, postoperatively or after trauma) in 28 cases with severe neurosurgical disease.Parenteral nutrition was adopted when EN was insufficient.Dose of glucose was limited at early period(acute phase,5～7 days after occurrence). Results:23 cases were cured and 5 cases died.During the period of EN,glucose and lipid metabolic abnormality or liver enzyme change were not found.There was no complication such as severe diarrhea,belly bulge.All patients who were on respiration machine were all taken off successfully. Conclusions:Early EN can improve the rate of cure and reduce the complication and mortality.

关 键 词：营养支持治疗 神经外科 危重病人 肠内营养 肠外营养 

分 类 号：R459.3[医药卫生—治疗学] R651[医药卫生—临床医学]