颅脑损伤患者早期肠内营养支持

The early enteral nutrition after severe head injury

目的 :研究在重型颅脑损伤患者中开展早期肠内营养支持的可行性 ,总结可能影响肠内营养支持的常见并发症的防治。方法 :对 2 0例重型颅脑损伤患者 ,开展早期肠内营养支持治疗 ,对颅脑损伤早期和肠内营养支持期间可能影响营养支持的并发症进行分析总结。结果 :118例患者在伤后 5～ 7天内达到 15 0 0～ 2 0 0 0 m L/d的鼻饲量 ;2创伤后 1周内患者的消化道并发症以腹胀、呕吐、胃内容物反流和误吸多见 ,1周后则以腹泻和便次增多多见 ,多数情况下不必停止肠内营养支持而仅需对症处理即可缓解症状 ;35例患者在创伤早期存在不同程度的上消化道出血 ,其中 4例仍按常规进行肠内营养支持 ,均耐受良好。结论 :多数重型颅脑损伤患者能在伤后 5～

Objective: It is to demonstrate the feasibility of early enteral nutrition after severe head injury and to clarify the prevention and treatment of common complications of enteral nutrition. Methods: From May 1999 to November 1999, 20 patients diagnosed with severe head injury were performed early enteral feeding for supportive nutrition in department. The complications within feeding period were analyzed. Results: ①In 18 patients, the total amount of 1500~2000mL/day of nutritional fluid was achieved within 5~7days after trauma via nasal tube feeding. ②The common complications of digestive tract within one week post trauma were abdominal distention, vomiting, reflux of gastric contents and misnhalation, while diarrhea and increased defecation were the most common complications one week later. Usually the complications could be relieved with expectant treatment. ③Upper gastrointestinal hemorrhage was seen in five patients at the early stage of trauma, however four patients still received enteral nutrition with satisfactory outcome. Conclusion: Sufficient nutrition can be obtained within 5~7 days in most of severe head injury patients through early enteral nutrition.