脑外科重症病人肠内营养相关并发症分析

Enteral nutrition related complications in severe brain-injured patients

目的：观察脑外科重症病人早期肠内营养支持中相关并发症的发生及其相关因素。方法：将78例收住ICU接受肠内营养支持脑外科重症病人（GCS为4～8分），按GCS评分，分为特重症组及一般重症组两组，观察肠内营养喂养量、输注速度、EN天数、血清清蛋白及肠内营养的耐受情况，总结各种肠内营养并发症的发生率。结果：脑外科重症病人在输注速度、最大耐受量、腹泻、腹胀等并发症方面均有明显不同。特重症组肠内营养液输注速度、最大维持量等，均低于一般重症组，EN天数、腹泻、腹胀的发生率高于一般重症组；腹泻发生与ALB、GCS评分水平呈负相关，与输注速度呈正相关。结论：肠内营养相关的胃肠道并发症，与疾病的严重程度、肠内营养输注速度和用量、血清清蛋白水平等因素相关。

Objecive ：To observe the incidence of early enteral nutrition-related complications in severe brain-injured patients in ICU and its associated factors. Methods ：78 nutrition severe brain-injured patients（ GCS 4-8 ） in ICU receiving enteral nutrition were all carried out for GCS scoring. The enteral feeding amount and speed, serum albumin （ALB） and intestinal feeding tolerance were observed. The incidence rate of all kinds of complications related to enteral nutrition was summarized. Results ： The patients with lower GCS had lower total feeding amount, prolonged feeding duration and higher incidence rate of complications. The diarrhea was negatively related with serum ALB level and GCS. Conclusion ：Enteral nutrition-related complications are related with the severity of disease and Alb level. Some critically iU patients can not sustain total enteral nutrition（TEN）, and parenteral nutrition is necessary.