肠内营养支持时机对重型颅脑损伤患者预后的影响.docVIP

肠内营养支持时机对重型颅脑损伤患者预后的影响 　　[摘要]目的 探讨肠内营养支持时机对重型颅脑损伤患者预后的影响。方法 选取2013年6月～2015年9月我院收治的重型颅脑损伤患者146例，随机分为治疗组74例和对照组72例。治疗组采用早期肠内营养支持治疗（24～48 h），对照组采用延迟肠内营养治疗（6～7 d）。观察两组患者治疗前后格拉斯哥昏迷指数（GCS）评分、营养指标及氮平衡的情况和住院期间并发症的发生率。结果 治疗后，治疗组GCS各相关指标均优于对照组（P0.05），治疗组患者的总蛋白、清蛋白、总淋巴细胞计数、氮平衡的恢复优于对照组（P0.05），住院期间治疗组呼吸道感染、消化道出血、胃肠道不适、高血糖的发生率均低于对照组，差异均有统计学意义（P0.05）。结论 24～48 h内给予肠内营养支持可以明显改善重型颅脑损伤患者的GCS评分、营养指标及氮平衡。 　　[关键词]重型颅脑损伤；肠内营养；临床研究 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-4721（2017）11（a）-0043-03 　　Effect of enteral nutrition support time on prognosis of patients with severe craniocerebral injury 　　ZHOU Hai TENG Hong-wei ZHOU Jing QIU Jing-song GAO Feng YANG Hua WANG Guo-jun PU Pu 　　YANG Zi-wei 　　Department of Neurosurgery，the People′s Hospital of BinhaiCity ，Jiangsu Province， Binhai，245000，China 　　[Abstract]Objective To investigate the effect of the time of enteral nutrition support on prognosis of patients with severe craniocerebral injury.Methods 146 cases of severe craniocerebral injury patients from June 2013 to September 2015 were randomly divided into treatment group（n=74） and control group （n=72）.The treatment group was given early enteral nutrition therapy （24-48 h），the control group was given delayed enteral nutrition treatment （6-7 d），The GCS score，nutritional index and nitrogen balance before and after treatment as well as the incidence of complications were observed.Results After treatment，the Glasgow coma index of the treatment group were better than the control group（P0.05）.The total protein，albumin，total lymphocyte count，nitrogen balance recovery of patients in the treatment group were better than the control group（P0.05）.The incidence of respiratory tract infection，gastrointestinal bleeding，gastrointestinal discomfort and hyperglycemia in the treatment group were lower than those in the control group，the difference was statistically significant （P0.05）.Conclusion Enteral nutrition support within 24-48 h can significantly improve the GCS score，nutritional index and ni