早期合理肠内外联合营养对重型颅脑损伤术后长期昏迷患者营养状况及预后的影响.docVIP

早期合理肠内外联合营养对重型颅脑损伤术后长期昏迷患者营养状况及预后的影响 　　[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长期昏迷患者营养状况及预后的影响。 方法 将118例2014年8月～2015年9月于我院外科确诊为重型颅脑损伤术后并住院的患者纳入研究并随机分组，对照组60例患者采用肠内营养治疗，观察组58例采用肠内外营养联合治疗。观察两组患者治疗前后血红蛋白、白蛋白、总蛋白及格拉斯哥昏迷指数（GCS评分）改善情况；比较两组患者免疫功能指标（IGA、IGM、IGG）改善情况及并发症肺部感染、胃肠道功能紊乱的发生率。 结果 治疗后观察组血红蛋白、白蛋白、总蛋白、GCS评分、免疫功能指标水平均高于对照组，并发症发生率低于对照组（P0.05）。 结论 早期合理肠内外联合营养可改善重型颅脑损伤术后长期昏迷患者营养状态，提高机体免疫力，降低肺部感染等并发症发生率，值得推广。 　　[关键词] 早期合理；肠内外联合营养；重型颅脑损伤；营养状况；预后 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721（2016）01（c）-0040-04 　　[Abstract] Objective To investigate the effect of reasonable combined enteral and parenteral nutrition in the early stage on the nutritional status and prognosis of patients with long period of coma after the surgery on severe craniocerebral injury. Methods 118 patients diagnosed severe craniocerebral injury and hospitalized in the surgical department of our hospital from August 2014 to September 2015 were enrolled into the study and randomly divided into the control group and observation group.The 60 patients in the control group were treated with enteral nutrition，while the 58 patients in the control group were treated with combined enteral and parenteral nutrition.The improvement of hemoglobin，albumin，total protein and Glasgow Coma Scale （GCS score） of the two groups before and after treatment were observed.The improvement of immune function（IgA，IgM，IgG）and the incidence of complicated pulmonary infection and gastrointestinal dysfunction were compared between the two groups. Results After treatment，the level of hemoglobin，albumin，total protein，GCS score，immune function indexes of the observation group was higher than that of the control group respectively，while the incidence of complications was lower（P0.05）. Conclusion The reasonable combined enteral and parenteral nutrition in the early stage can improve the nutritional status of patients with long period of coma after the surgery on severe craniocerebral injury，enhance their immunity and reduce the incidence of c