重型颅脑损伤术后不同营养方式对颅内感染影响的探讨

Effects of Different Postoperative Nutrition Support on Rate of Intracranial Infections in Patients with Severe Craniocerebral Injury

目的观察重型颅脑损伤术后不同营养方式对颅内感染的影响。方法将两家医院2001年1月-2009年10月收治的符合条件的326例重型颅脑损伤病例,术后1周内按营养方式不同分组。术后48 h内肠内营养(enteral nu-trition,EN)治疗组182例(EN组);术后肠外营养(parenteral nutrition,PN)治疗组144例(PN组)。观察两组术后颅内感染发生率和抗生素使用平均时间。结果两组病例术前年龄、性别、GCS评分比较差异无统计学意义(P>0.05);术后EN组颅内感染率6.05%,PN组颅内感染率18.75%。两组感染率比较差异有统计学意义(P<0.05);EN、PN组抗生素使用时间分别为(5.02±0.48)d、(8.35±1.71)d,两组抗生素使用时间比较,EN组抗生素使用时间明显缩短(P<0.05)。结论术后早期、规范的EN,是降低重型颅脑损伤术后颅内感染的重要措施之一。

Objective To observe the effects of different postoperative nutrition support on rate of intracranial infections in patients with severe craniocerebral injury.Methods Three hundred and twenty six eligible patients with severe craniocerebral injury from two hospitals from January 2001 to October 2009 were divided into two groups according to the different postoperative nutrition support one week after the operation.48h after the surgery,EN group（182 cases） received enteral nutrition（EN）,while PN group（144 cases） received parenteral nutrition.The incidence of postoperative intracranial infection and average time of using antibiotics were observed.Results There was no significant difference in the age,sex,GCS score in both groups before the operationi（P＆gt;0.05）.After the operation,the rate of intracranial infection in was 6.05% EN group and 18.75% in PN group,the difference was significant（P＆lt;0.05）.The average time of using antibiotics was（5.02±0.48） d in the EN group and（8.35±1.71） d in PN group,the difference between the two groups was statistical significant（P＆lt;0.05）.Conclusion The early postoperative and standard EN is an important measure to reduce the rate of intracranial infections in patients with severe craniocerebral injury.