摘要
目的探讨早期合理肠内外联合营养对重型颅脑损伤术后昏迷患者营养状况的影响研究。方法将2016年1月~2019年6月在我院神经外科治疗的60例重型颅脑损伤术后昏迷患者随机分为两组,对照组仅给予早期肠内营养,观察组给予早期合理肠内外联合营养,比较两组患者的营养状况、ADL和QOL评分变化、并发症发生率以及预后。结果观察组治疗7d后的血红蛋白、白蛋白、总蛋白水平明显高于对照组(P<0.05);观察组治疗7、14d的ADL评分、QOL评分明显高于对照组(P<0.05);观察组恶心呕吐、胃食管反流、腹胀腹泻、消化道出血、便秘、肺部感染等并发症发生率以及死亡率明显低于对照组(P<0.05);观察组治疗7、14d后的GCS评分明显高于对照组(P<0.05)。结论早期合理肠内外联合营养对重型颅脑损伤术后昏迷患者营养状况有明显改善作用,降低胃肠功能紊乱及肺部感染发生率,改善预后,减少死亡率,具有积极的临床意义。
Objective To investigate the study on the effects of early rational enteral and parenteral nutrition on the nutritional status of coma patients after surgery for severe craniocerebral injury.Methods 60 coma patients after surgery for severe craniocerebral injury treated at the Department of Neurosurgery of our hospital from January 2016 to June 2019 were randomly divided into two groups.The control group was only given early enteral nutrition,while the observation group was given early rational enteral and parenteral nutrition.The nutritional status,changes in ADL and QOL scores,incidence of complications and prognosis of the two groups of patients were compared.Results Hemoglobin,albumin and total protein levels after 7d of treatment in the observation group were significantly higher than those in the control group(P<0.05);ADL scores and QOL scores after 7d and 14d of treatment in the observation group were significantly higher than those in the control group(P<0.05);The incidence of complications such as nausea and vomiting,gastroesophageal reflux,abdominal distension and diarrhea,gastrointestinal bleeding,constipation,pulmonary infection,etc.and the mortality in the observation group were significantly lower than those in the control group(P<0.05);GCS scores after 7d and 14d of treatment in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Early rational enteral and parenteral nutrition can significantly improve the nutritional status of coma patients after surgery for severe craniocerebral injury,reduce the incidence of gastrointestinal dysfunction and pulmonary infection,improve prognosis,reduce mortality,and have positive clinical significance.
作者
叶锦欢
林立超
杨建雄
叶志其
YE Jinhuan;LIN Lichao;YANG Jianxiong;YE Zhiqi(Department of Neurosurgery,Heyuan People's Hospital,Heyuan 517000,China)
出处
《中国医药科学》
2020年第7期256-259,共4页
China Medicine And Pharmacy
关键词
重型颅脑损伤
术后昏迷
早期合理肠内外联合营养
营养状况
免疫功能
预后
Severe craniocerebral injury
Postoperative coma
Early rational enteral and parenteral nutrition
Nutritional status
Immune function
Prognosis
