早期肠内营养在重型颅脑损伤病人中的合理应用

The appropriate application of early enteral nutrition in patients with severe brain injury

目的：探求早期肠内营养对重型颅脑损伤病人血糖、蛋白质代谢和并发症的影响。方法：将40例重型颅脑损伤病人随机分成两组，即试验组于术后48～72h给予改良匀浆膳治疗，对照组给予能全力治疗，不足部分由肠外营养补充。在营养支持第1、15和30天分别检测两组病人的血糖、血清清蛋白、转铁蛋白、血红蛋白、氮平衡和并发症。结果：血糖、蛋白质代谢在两组得到明显改善（P〈0．01，P〈0．05），试验组与对照组相比，血糖和氮平衡改善更为明显（P〈0．05）。结论：对董型颅脑损伤病人早期实施肠内营养是一项重要措施，改良匀浆膳与能全力相比有降低血糖和促进氮平衡的作用。

Objective： To investigate the influence of early enteral nutrition on blood glucose , serum proteins, nitrogen balance and complications in patients with severe brain injury. Methods： 40 cases of severe brain injury were randomly divided into experimental group and control group. The experimental group was treated by homogenized diet and the control group was treated by nutrison fibre . Parenteral nutrition was adopted when enteral nutrition was insufficient. The levels of blood glucose ,serum proteins ,nitrogen balance and complications were measured during nutrition support （1 d, 15 d, 30 d）. Results： Glucose and protein metabolism were significantly improved in two group（ P 〈 0.01 ,P 〈 0.05 ）. Compared with control group, blood glucose and nitrogen balance were significantly improved （ P 〈 0.05 ） in experimental group. Conclusion： Early enteral nutrition treatment is important in patients with severe brain injury. Compared with nutrison fibre, homogenized diet is more effective and economic.