重型颅脑损伤患者营养支持的临床研究

A clinical study of nutritional support in patients with severe head injury

目的 探讨重型颅脑损伤营养支持的临床疗效及最佳途径。方法 6 4例重型颅脑损伤患者随机分为肠内营养组 (EN组 )和肠外营养组 (PN组 ) ,急诊手术后 36～ 48h开始经不同途径进行额定热卡和氮量的营养支持 ,监测各项营养指标、代谢指标及营养支持并发症 ,计算营养费用。结果 EN与PN均有效地维持了各项营养指标 ,但PN组代谢指标、营养支持并发症及营养费用均显著高于EN组。结论 早期积极的营养支持能改善机体的营养状况。PN与EN均能获得满意疗效 ,而EN更具有营养全面、简易安全、方便价廉等优点 。

Objective To explore the clinical therapeutic efficacy and the best way of nutritional support in patients with severe head injury.Methods 64 patients with severe head injury were divided into enteral nutrition group(ENG) and parenteral nutrition group(PNG) at random.After treated by emergency operations and kept fast for 36～48 hours,all the patients received the ration nitrogen and the ration calorie nutritional support in different pathway.At the same time,we monitored the nutritional index,the metabolic index,the complications of nutritional support and calculating the nutritional costs during the whole treatment.Results The nutritional index were kept effectively in both ENG and PNG,but the metabolic index,the complications of nutritional support and the nutritional costs of the PNG rose more obviously than those of the ENG.Conclusions Early active nutritional support can improve the nutritional states of the body.Both EN and PN can obtain satisfactory clinical therapeutic efficacy,but EN has more benefits,including comprehensive nutrition,safety,convenience and low cost.It should be the first choice of nutritional support. [