重型颅脑损伤患者肠内营养对减少肠道多重感染的研究

Effect of enteral nutrition on reduction of incidence of intestinal multiple infections in patients with severe craniocerebral injury

目的研究肠内营养混悬液(SP)对减少重型颅脑损伤(SCI)患者肠道多重感染(IMI)的效果,为临床治疗提供理论依据。方法选取医院2013年5月-2014年5月收治的重型颅脑损患者268例作为研究对象,以数字法随机分为观察组和对照组两组各134例,对照组患者给予肠外营养,观察组患者给予百普力肠内营养混悬液进行肠内营养,观察并对比两组患者治疗后腹泻、便秘、肠道多重感染等发生率、患者ICU住院、首次排便、肠内营养达标时间,两组患者治疗前后体质量指数(BMI)以及腹壁皮皱厚度等。结果观察组患者治疗后腹泻、便秘、肠道多重感染等发生率分别为8.96%、8.21%、30.60%,均显著低于对照组的18.66%、20.15%、50.00%,差异均有统计学意义(P<0.05);观察组患者ICU住院、首次排便及肠内营养达标时间分别为(7.52±3.23)(4.13±1.26)(3.89±0.62)d,均显著少于对照组的(11.31±6.85)(6.98±1.15)(6.31±3.08)d,差异均有统计学意义(P<0.05);两组患者的BMI及腹壁皮皱厚度在治疗前后的差异均无统计学意义。结论百普力肠内营养能够显著降低重型颅脑损患者肠道多重感染发生率,减少患者腹泻、便秘症状发生。

OBJECTIVE To explore the effect of enteral nutritional suspension on reduction of incidence of intestinal multiple infections（IMI）in the patients with severe craniocerebral injury（SCI）so as to provide theoretical basis for clinical treatment.METHODS A total of 268 patients with SCI who were treated in the hospital from May 2013 to May 2014 were recruited as the study objects and randomly divided into the observation group with 134 cases and the control group with 134 cases.The control group was treated with parenteral nutrition,while the observation group was given the enteral nutrition with enteral nutritional suspension.The incidence rates of diarrhea,constipation,and intestinal multiple infections,length of ICU stay,first defecation,and time of enteral nutrition to meet the standard were observed and compared between the two groups of patients after the treatment.The body mass index（BMI）and thickness of folded abdominal walls were observed as well before and after the treatment.RESULTS The incidence of diarrhea of the observation group was 8.96% after the treatment,significantly lower than 18.66% of the control group;the incidence rate of constipation of the observation group was 8.21%,significantly lower than 20.15% of the control group;the incidence of intestinal multiple infections of the observation group was 30.60%,significantly lower than 50.00% of the control group;the difference was statistically significant（P〈0.05）.The length of ICU stay of the observation group was（7.52±3.23）days,significantly shorter than（11.31±6.85）days of the control group;the time of first defecation of the observation group was（4.13±1.26）days,significantly shorter than（6.98±1.15）days of the control group;the time of enteral nutrition to meet the standard of the observation group was（3.89±0.62）days,significantly shorter than（6.31±3.08）days of the control group,with significant difference（P〈0.05）.There was no statistically significant difference in the BMI or thickness of folded abdominal walls between the two groups of patients.CONCLUSION The enteral nutritional suspension can significantly reduce the incidence rates of the intestinal multiple infections,diarrhea,or constipation in the patients with severe craniocerebral injury.