摘要
目的探讨早期肠内-肠外联合营养对颅内血肿清除术后气管切开患者的应用效果。方法2018年6月至2019年12月安徽省阜阳市第二人民医院收治的78例颅内血肿清除术后气管切开患者,按照随机数字表法分为肠外组、肠内组和联合组,每组各26例。分别给予单纯肠内营养、单纯肠外营养、早期肠内-肠外联合营养治疗。比较三组营养干预前后营养状况、免疫水平及短期预后情况。结果三组干预后血总蛋白(TP)、前白蛋白(PA)、白蛋白与转铁蛋白(TRF)水平均高于干预前(P<0.05)。联合组干预后血TP、PA与TRF水平均高于肠外组,血PA、TRF水平均高于肠内组(P<0.05);肠内组干预后血PA、TRF水平均高于肠外组(P<0.05)。三组干预后血IgM、IgG、IgA水平均高于干预前(P<0.05)。联合组干预后血IgM、IgG、IgA水平均高于肠外组,血IgM、IgA水平均高于肠内组(P<0.05);肠内组干预后的血IgA水平均高于肠外组(P<0.05)。三组干预后GCS评分均高于干预前(P<0.05)。三组消化道不耐受发生率比较,差异无统计学意义(P>0.05)。联合组上消化道出血发生率低于肠外组(P<0.02)。联合组总住院天数短于肠外组和肠内组(P<0.05)。结论早期肠内-肠外联合营养能显著改善颅内血肿清除术后气管切开患者术后免疫功能与营养状况。
Objective To investigate the application effect of early enteral combined with parenteral nutrition on patients with tracheotomy after resection of intracranial hematoma. Methods Seventy-eight patients with tracheotomy incision after resection of intracranial hematoma admitted to Fuyang Second People’s Hospital from June 2018 to December 2019 were divided into parenteral group, enteral group, and combined group by random number table method, with 26 cases in each group. Enteral nutrition alone, parenteral nutrition alone, and early enteral combined and parenteral nutrition were given respectively. The nutritional status, immune level and short term prognosis were compared before and after nutrition intervention among three groups. Results The levels of total protein(TP),prealbumin(PA), albumin, transferrin(TRF) in the three groups after intervention were higher than those before intervention(P < 0.05). After intervention, the levels of TP, PA, and TRF in combined group were higher than those in parenteral group, and the levels of PA and TRF in combined group were higher than those in parenteral group(P <0.05). The levels of PA and TRF in enteral group were higher than those in parenteral group(P < 0.05). The levels of serum IgM, IgG, and IgA in three groups were higher than before intervention(P < 0.05). After intervention, serum IgM,IgG, and IgA levels in combined group were significantly higher than those in parenteral group, and serum IgM and IgA levels in combined group were significantly higher than those in enteral group(P < 0.05). The level of IgA in enteral group after intervention was higher than that in parenteral group(P < 0.05). GCS scores of three groups after intervention were higher than before(P < 0.05). There was no significant difference in the incidence of gastrointestinal intolerance among the three groups(P > 0.05). The incidence of upper gastrointestinal bleeding in combined group was lower than that in parenteral group and enteral group(P < 0.05). The total length of hospitalization in co
作者
马炬侠
陈丽
王瑞杰
佟玲玲
MA Juxia CHEN Li;WANG Ruijie;TONG Lingling(Department of Neurosurgery,Fuyang Second People’s Hospital,Anhui Province,Fuyang 236008,China)
出处
《中国医药导报》
CAS
2022年第13期92-95,共4页
China Medical Herald
基金
安徽省自然科学基金项目(19MH180923)。
关键词
肠内营养
肠外营养
颅内血肿切除术
气管切开术
免疫功能
预后
Enteral nutrition
Parenteral nutrition
Resection of intracranial hematoma
Tracheotomy
Immune function
Prognosis
