生长激素加早期肠内营养对重度脑损伤患者术后营养状况及并发症的影响

The effect of growth hormone plus early enteral nutrition on nutritional status and complications in postoperative patients after severe brain injuries

目的探讨生长激素(growth hormone,GH)加早期肠内营养对重度脑损伤患者术后营养状况及并发症的影响。方法将66例患者随机分成治疗组和对照组,每组33例。治疗组术后第2天开始肠内营养(enteral nutrition,EN)支持,同时每天联合应用GH,连用2周。对照组术后第2天开始胃肠外营养(parenteral nutrition,PN)支持,测定手术当天和第14、21天的多项营养指标,并观察两组的临床疗效和并发症。结果治疗组血清前清蛋白、转铁蛋白、清蛋白均明显高于对照组(P<0.05),肺部感染、应激性溃疡和电解质紊乱发生率明显低于对照组(P<0.05),平均入住ICU时间明显短于对照组(P<0.05)。结论生长激素联合早期肠内营养,不但可迅速改善重度脑损伤患者术后的营养状况,减少并发症,而且可缩短入住ICU的时间。

Objective To study the effect of growth hormone （GH） plus early enteral nutrition （EEN） on nutritional status and complications in postoperative patients after severe brain injuries. Methods Sixty - six patients were randomly divided into treatment group and control group. The treatment group （33 cases） received enteral nutrition support on the 2nd day after operation, and growth hormone was added for two weeks. The control group （33 cases） received total parenteral nutrition （PN） support. The clinical effect and complications were compared between the two groups. Results The patients＇ serum prealbumin , transferrin and albumin in the treatment group were much better than those in the control group （ P 〈 0.05 ）. The incidence of pulmonary infection, stress - related gastric injury and electrolyte disturbance in the treatment group were significantly lower than those in the control group （P 〈 0.05 ）. Conclusion Growth hormone combined with early enteral nutrition can improve nutritional status and reduce complications.