早期肠内营养支持对重型颅脑损伤患者预后的影响

Effects of early enteral nutrition support on prognosis in patients with severe craniocerebral injury

目的 探讨早期肠内营养支持对重型颅脑损伤患者预后的影响.方法 160例重型颅脑损伤患者,采用数字表法随机分为对照组80例、观察组80例,两组患者均采用常规方法治疗,观察组给予早期肠内营养支持,对照组给予常规营养,观察治疗10 d后CD3^＋、CD4^＋、IgE、IgG等免疫因子的改善情况.结果 治疗10 d后,观察组血清IgG、IgM、IgA显著高于对照组（t=2.18、3.42、11.23,均P＜0.05）,IgE显著低于对照组（t =4.76,P＜0.05）；观察组血清T淋巴细胞亚群CD3^＋、CD4^＋水平值均高于对照组（t=21.41、5.38,均P＜0.05）；观察组并发症发生率为23.75%,显著低于对照组的55.00%（χ^2=4.73,P＜0.05）.结论 早期肠内营养支持治疗可显著提高重型颅脑损伤患者的免疫功能,减少并发症,从而改善预后,提高患者的生存质量.

Objective To investigate the impact of early enteral nutrition on the prognosis of severe head injury patients.Methods According to the different nutritional therapy,160 cases of severe craniocerebral injury patients were randomly divided into two groups using random digit.Two groups of patients were all given similarly conventional methods,the observation group were given early enteral nutrition therapy,the control group were given routine nutrition.CD3＋,CD4＋,IgE,IgG immune factors were observed after treatment for 10d.Results 10d later,the serum IgG,IgM,IgA in the observation group were significantly higher than those in the conventional nutrition group（t =2.18,3.42,11.23,all P 〈 0.05）,IgE was significantly lower than that in the conventional nutrition group （t =4.76,P 〈 0.05） ;The serum T-lymphocyte subsets CD3^＋,CD4^＋ level in the observation group were higher than those in the conventional nutrition group（t =21.41,5.38,all P 〈 0.05）,the incidence of complications of the observation group was 23.75%,which was significantly lower than 55.00% in the conventional nutrition group（χ^2 =4.73,P 〈 0.05）.Conclusion Early enteral nutrition therapy can significantly improve the immunity of severe head injury patients,reduce complications,thereby improve the prognosis and the patient＆#39;s quality of life.