急性脑损伤高钠血症鼻饲治疗临床对比研究.docVIP

急性脑损伤高钠血症鼻饲治疗临床对比研究 　　[摘要] 目的 分别通过米汤、清水鼻饲和静脉输液治疗急性脑损伤高钠血症，比较其纠正重症高钠血症的临床效果。方法 整群收集该院2013年11月―2015年9月间收治的132名急性脑损伤的高钠血症患者，分为米汤鼻饲治疗组54例，清水鼻饲治疗组45例，静脉输液对照组33例。比较3组患者出现高钠血症的血钠水平、血钠恢复正常所需时间、肠鸣音恢复所需时间、胃内容物隐血、死亡率及米汤和清水鼻饲并发症情况。 结果 3组患者性别、年龄、APACHII评分、出现高钠血症及血钠恢复时的血钠值之间均差异无统计学意义（P0.05）；米汤组血钠恢复所需时间（87.74±6.64）h与清水组血钠恢复时间（90.17±8.14）h比较差异无统计学意义（P0.05），但都短于对照组（183.26±11.31）h，（P0.05），均明显低于对照组63.63%，（P0.05）。结论 鼻饲是一种简便、安全的纠正高钠血症的治疗方法，使用米汤鼻饲能使患者肠功能较快恢复，且并发症少，值得临床推广应用。 　　[关键词] 高钠血症；鼻饲；米汤；清水 　　[中图分类号] R473.74 [文献标识码] A [文章编号] 1674-0742（2016）04（a）-0007-04 　　[Abstract] Objective To compare the clinical effects of rice water nasal feeding， clear water nasal feeding and venous transfusion in treatment of acute brain injury and hypernatronemia. Methods 132 cases of patients with acute brain injury and hypernatronemia admitted and treated in our hospital form November 2013 to September 2015 were collected and divided into the rice water nasal feeding treatment group with 54 cases， clear water nasal feeding treatment group with 45 cases and venous transfusion control group with 33 cases， the hyponatremia level， hyponatremia returning to normal time， recovery time of borborygmus， gastric content occult blood， death rate and complications of rice water and clear water nasal feeding were compared between the three groups. Results There was no obvious difference in the gender， age， APACHII score， hyponatremia values at the time of occurrence of hyponatremia and recovery of hyponatremia between the three groups（P0.05）， the difference in the recovery time of hyponatremia between the rice water group and the clear water group had no statistical significance，[（87.74±6.64） h vs （90.17±8.14） h]，（P0.05）， but the recovery time of hyponatremia in the two groups was shorter than that in the control group， which was（183.26±11.31） h，（P0.05）， and the death rate in the two groups was fewer than that in the control group， which was 63.63%，（P 　　[Key words] Hypernatronemia； Nasal feeding； Rice water； Clea