早期肠内营养支持在重型颅脑损伤治疗中的作用

Role of early enteral nutrition on the treatment of severe traumatic brain injury

目的探讨早期肠内营养支持在重型颅脑损伤治疗中的作用。方法将符合条件的患者随机分为治疗组和对照组，治疗组于伤后36～48h置胃管开始能全力鼻饲，对照组于受伤2d后予肠外营养支持，待肠鸣音出现后（约5～7d）开始渐转为肠内营养。两组在营养支持前及2w后分别测定血生化指标：血清总蛋白（TP）、白蛋白（ALB）、血红蛋白（Hb）及淋巴细胞总数（TLC）、肝功、肾功、血糖、电解质，同时观察各组在治疗中并发症发生情况。结果治疗组的营养指标明显优于对照组（P〈0．05），并发症低于对照组（P〈0．05）。结论早期肠内营养支持能使严重颅脑损伤的患者获得较多的热能和蛋白质，增加机体抵抗力，纠正负氮平衡，促进创伤组织和神经功能恢复，减少并发症的发生。

Objective To explore the role of entcral nutrition on the early treatment of severe traumatic brain injury. Methods 60 qualified patients （GCS≤8） were randomly divided into two groups： treatment group and control group. The patients of treatment group were treated with enteral nutrition 36 ~ 48 hours after injury, and the other patients were treated with parenteral nutrition 48 hours after injury. Then to compare the difference of some nutrition indexes and complications of the two groups. Results The nutrition indexes of treatment group were more superior than that of control group, and the occurrence of complications of treatment group was more less. Conclusion Early enteral nutrition can offer more heat energy and protein, promote the immunity and re- covery, and reduce the occurrence of complications, of the treatment group.