早期应用胃肠内乳剂对重型颅脑损伤患者低蛋白血症的防治效果分析

Early Application of Enterai Emulsions On Severe Traumatic Brain Injury Prevention and Treatment of Patients With Hypoproteinemia Effect

目的：观察早期（伤后48h～3周）应用胃肠内乳剂瑞代支持治疗重型颅脑损伤对降低低蛋白血症的临床效果分析。方法：将69例入选病例随机分为实验组和对照组，实验组35例早期应用胃肠内营养乳剂瑞代，对照组34例按传统方法鼻饲流质饮食，其余治疗两组无差异。于伤后48h内分别开始使用胃肠内营养乳剂（瑞代）胃管注入和传统方法鼻饲流质饮食，两种不同营养治疗持续期限为21d，观察两组患者血清白蛋白（ALB）和血清总蛋白（TP）的动态变化。结果：低蛋白血症实验组发生率为14．3％，对照组发生率为38．3％，实验组明显低于对照组（χ^2=5．13，P〈0．05），ALB实验组为（36．87±5．47）g／L，对照组为（33．41±5．26）g／L，TP实验组为（67．12±8．27）g/L，对照组为（63．67±9．16）g／L，实验组明显高于对照组（P〈0．05）。实验组对预防和降低低蛋白血症的发生效果明显，与对照组相比可显著降低低蛋白血症的发生。结论：早期胃肠内营养乳剂瑞代应用在重型颅脑损伤病人的治疗中非常重要，对减少重型颅脑损伤后继发低蛋白血症有明确效果。

Objective Observed early （after injury, 48h-3 weeks） application on behalf of Swiss support gastrointestinal emulsion treatment of severe traumatic brain injury to reduce the clinical effects of low serum protein analysis.Methods Sixty-nine eases selected were randomly divided into experimental and control groups, Experimental group, 35 eases of early enteral nutrition emulsion, Control group of 34 patients according to traditional methods of nasal liquid diet.There was no difference between the remaining treatment. Within 48h after injury, respectively, to start using parentera/nutrition emulsion and traditional methods of nasal feeding tube into the liquid diet, Two different nutrition therapy continued for a period of 21d, Observed in patients with serum albumin （ALB） and serum total protein （TP） of the dynamic ehanges.ResultsThe incidence rate of hypoproteinemia of experimental and control groups were 14.3%, and 38.3% respectively. Significant difference was found between the two groups （ χ^2=5.13 ,P〈0.05）.The TP contents of experimental groups and control group （36.87 ± 5.47）g/L and （33.41 ±5.26）g/L. The ALB contents of experimental groups and control greup（36.87 ±5.47）g/L,and （33.41±5.26）g/L.ALB and TP contents in experimental groups were significantly higher compared with the control group.Conclusion Early enteral nutrition emulsion applications in the treatment of severe head injury is very important to reduce severe head injury secondary to hypoproteinemia has a clear effect.