早期肠内营养支持治疗急性重型颅脑损伤患者的疗效观察被引量：3

Clinical observation of early enteral nutrition support for patients with acute severe head injury

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摘要目的探讨急性重型颅脑损伤患者应用早期肠内营养支持的临床效果。方法将2011年3月～2014年2月重症医学科收治的急性重型颅脑损伤患者70例,根据营养支持方法的不同分为两组。对照组27例采用传统方法鼻饲流质,观察组43例采用早期肠内营养支持。对比观察两组治疗前后营养状况指标：前白蛋白（PA）、白蛋白（ALB）、血红蛋白（Hb）和球蛋白（GLO）以及并发症发生率。结果两组治疗前各营养学指标比较差异均无统计学意义（P〉0.05）。与治疗前比较,观察组治疗后Hb显著降低（P〈0.05）,PA、ALB和GLO无明显变化（P〉0.05）;对照组治疗后PA、Hb和GLO均显著降低（P〈0.05）,ALB无明显变化（P〉0.05）;两组治疗后比较,观察组PA、GLO显著高于对照组（P〈0.01）,ALB和Hb略高于对照组,但差异无统计学意义（P〉0.05）。观察组并发症发生率为27.9%（12/43）,显著低于对照组的81.5%（22/27）,差异有统计学意义（P〈0.01）。结论早期肠内营养支持可以较好地维持急性重型颅脑损伤患者机体营养状况,且并发症少,值得临床推广。 Objective To explore clinical effect of early enteral nutrition support for patients with acute severe head injury. Methods 70 cases with acute severe head injury,who were admitted to ICU of our hospital from March,2011 to February,2014,were divided into observation group（ 43 cases） and control group（ 27 cases） according to the different methods of nutritional support. The control group were given traditional drip feed,while the observation group were given early enteral nutrition support. Then,indexes of nutritional status including prealbumin（ PA）,albumin（ ALB）,hemoglobin（ Hb）,globulin（ GLO） and incidence of complications before and after treatment were compared between two groups. Results No statistical significance was found in the comparison of the indexes of nutritional status between two groups before treatment（ P〉0. 05）.Compared with that before treatment,Hb of the observation group decreased significantly after treatment（ P〈0. 05）,while their PA,ALB and GLO had no significant change（ P〉0. 05）; PA,Hb and GLO of the control group decreased significantly after treatment（ P〈0. 05）,but their ALB had no significant change（ P〉0. 05）. After treatment,PA and GLO of the observation group were significantly higher than those of the control group（ P〈0. 01）; and ALB and Hb of the observation group were also higher than those of the control group,but there was no significant statistical difference（ P〉0. 05）. The incidence of complication of the observation group was 27. 9%（ 12 /43）,significantly lower than that（ 81. 5%,22 /27） of the control group,so the difference was statistically significant（ P〈0. 01）. Conclusion Early enteral nutrition support can better maintain the organism nutrition status of patients with acute severe head injury and causes fewer complications. Thus,it＇s worthy of promotion in clinic.