重型颅脑损伤患者营养支持的临床疗效观察

Clinical effect observation of nutritional support in patients with severe craniocerebral injury

目的探讨早期肠内营养支持在重型颅脑损伤治疗中的作用。方法选择本院2010年1月～2014年1月收治入院的符合条件的重型颅脑损伤患者200例，随机分为观察组和对照组，两组患者均进行常规性治疗，观察组在治疗期间给予合理的早期营养支持，对两组患者的身体指标及胃肠道功能进行评估，并记录有无并发症发生。结果两组患者伤后第1天氮平衡、肌酐／身高指数比较差异无统计学意义（P〉0．05）；两组患者伤后第4、7、28天氮平衡、肌酐／身高指数比较差异有统计学意义（P〈0．05）；两组患者伤后第14天肌酐／身高指数比较差异有统计学意义（P〈0．05）。两组患者伤后第1天血清白蛋白水平比较差异无统计学意义（P〉0．05）；两组患者伤后第7、14、28天血清白蛋白水平比较差异有统计学意义（P〈0．05）。两组患者伤后第l、7天TSF和AMC比较差异无统计学意义（P〉0．05）：两组患者伤后第14、28天r11sF和AMC比较差异有统计学意义（P〈0．05）。两组患者平时体重比较差异无统计学意义（P〉0．05）；两组患者伤后第28天体重、体重减少及体重减少百分率比较差异有统计学意义（P〈0．05）。观察组患者出现并发症46例次，对照组出现并发症113例次，两组比较差异有统计学意义（X2=23．926，P〈0．01）。结论严重颅脑损伤早期肠内营养支持有利于脑损伤患者尽早康复。

Objective To investigate effect of the early enteral nutrition support in the treatment of severe craniocerebral injury. Methods 200 cases of patients with severe craniocerebral injury from January 2010 to January 2014 admitted to our hospital were selected and randomly divided into observation group and control group,routine treatment was used in two groups,the early reasonable nutritional support during treatment was used in observation group.Physical index and gastrointestinal function in two groups was evaluated respectively,and with and without complication was recorded. Results Nitrogen balance,creatinine/height in two groups after injury of first day was compared respectively, with no statistical difference （P〉0.05）.Nitrogen balance,creatinine/height in two groups after injury of 4,7,28-day was compared respectively,with statistical difference （P〈0.05）.Creatinine/height in two groups after injury of 14-day was compared,with statistical difference （P〈0.05）.Serum albumin level in two groups after injury of first day was compared, with no statistical difference（P〉0.05）.Serum albumin level in two groups after injury7,14,28-day was compared respectively,with statistical difference（P〈0.05）.TSF,AMC in two groups after injury of 1,7-day was compared respectively,with no statistical difference （P〉0.05）.TSF,AMC in two groups after injury of 14,28-day was compared respectively,with statistical difference（P〈0.05）.Normal weight in two groups was compared,with no statistical difference（P〉0.05）.After injury of twenty-eighth days,weight loss and weight reduction percentage in two groups was compared respectively,with statistical difference（P〈0.05）.46 cases of patients with complication in observation group, 113 cases of patients with complication in control group,with statistical difference （x2=23.926,P〈0.01）. Conclusion Early enteral nutrition support applied in severe craniocerebral injury is conducive to the early recovery of patients with brain injury.