摘要
目的:观察鼻胃管减压术联合鼻肠管肠内营养支持对重症颅脑损伤患者预后的影响。方法:选取急诊科的重症颅脑损伤患者100例,采用随机数表法分为对照组和观察组各50例,对照组采用传统的鼻胃管进行营养支持,观察组患者采用鼻胃管减压术联合鼻肠管进行肠内营养支持。对两组患者的并发症发生情况、GCS评分、APACHEⅡ评分、住院天数、生活质量评分和炎症反应因子[(如血清肿瘤坏死因子(TNF-α)、白介素(IL)-6、血浆D-乳酸、血清肠型脂肪酸结合蛋白IFABP)]进行观察并比较。结果:两组患者实施14d肠内营养后,对照组患者误吸、胃潴留和肺炎的发生率显著高于观察组,差异有统计学意义(P<0.05),另外,肠内营养14d后,对照组CPIS评分显著高于观察组,两组比较差异有统计学意义(P<0.05);两组患者肠内营养支持14d后,观察组GCS评分显著高于对照组(P<0.05),另外肠内营养支持14d后,观察组APACHEⅡ评分和住院天数显著低于对照组(P<0.05);两组患者入院时的生活质量评分比较,差异不显著,但出院时和出院2个月时观察组生活质量评分均显著高于对照组(P<0.05);与对照比较,观察组患者实施肠内营养支持3d、7d和14d血清TNF-α、IL-6、血浆I-FABP的表达均显著降低,肠内营养支持7d后血浆D-乳酸水平降低,差异均有显著性(P<0.05)。结论:对重症颅脑损伤患者采用鼻胃管减压术联合鼻肠管肠内营养支持能有效降低患者的并发症如胃潴留、误吸等,降低吸入性肺炎的发生,降低患者的住院天数,提高患者的生活质量,抑制患者早期炎症反应的发生,改善患者的预后。
Objective:To observe the effect of nasogastric tube decompression combined with enteral nutrition support for patients with severe craniocerebral injury.Methods:100 patients with severe craniocerebral injury were divided into control group and observation group by random indicator method,50 patients in the control group used the traditional nasogastric tube for nutrition support,observation group of patients with nasogastric tube decompression combined nasal bowel enteral nutrition support.Complications occurred in two groups of patients,GCS score,APACHEⅡscore,hospitalization days,the quality of life score and inflammation factors(such as serum TNF tumor necrosis factor alpha and interleukin(IL)6,plasma D-lactic acid,serum type of intestinal fatty acid binding protein I-FABP)were observed and compared.Results:Two groups of patients after the implementation of 14 d enteral nutrition,the control group and gastric retention and aspiration pneumonia in patients with a significantly higher incidence of observation group,the difference was statistically significant(P<0.05),in addition,enteral nutrition after 14 d,observation group was significantly higher than control group in CPIS score,the more similar between the two groups was statistically significant(P<0.05);Two groups of patients with enteral nutrition support after 14 d,observation group GCS score was significantly higher than that of control group(P<0.05)and enteral nutrition support after 14 d,observation group APACHEⅡscore and hospitalization days was significantly lower than the control group(P<0.05);The quality of life scores of the two groups were not significantly different in admission,but the quality of life score in the observation group was significantly higher than that in the control group(P<0.05).Compared with control,observation group implement enteral nutrition support in patients with 3 D,7 D and 14 D serum TNF alpha,IL-6,plasma I-FABP expression were significantly lower,enteral nutrition support after 7 D plasma D-lactic acid level is redu
作者
王小军
Wang Xiaojun(The Emergency Department,Shangluo City Center Hhospital in Shaanxi(Shangluo 726000))
出处
《陕西医学杂志》
CAS
2018年第10期1290-1293,共4页
Shaanxi Medical Journal
关键词
颅脑损伤
@鼻胃管减压术
@鼻肠管
Craniocerebral trauma
@Nasogastric tube decompression
@Nasal tube
