经鼻空肠营养管在重型颅脑损伤肠内营养中的有效性和安全性

Efficacy and Safety of Enteral Nutrition by Nasal Jejunum Nutrient Canal On Severe Head Injury Patient

目的研究鼻空肠营养管在重型颅脑损伤患者肠内营养中的有效性及安全性。方法根据营养支持方式将重型颅脑损伤患者分为经鼻空肠营养管行肠内营养组（N＋EN组）、经胃管行肠内营养组（S＋EN组）和全肠外营养组（TPN组），比较三组研究对象疗效、治疗前后前白蛋白（PA）、白蛋白（ALB）、总蛋白（TP）、IgG、IgA、IgM的差异。结果N＋EN组和S＋EN组患者ICU时间、死亡率和肺外感染发生率显著低于TPN组患者（均P〈0．05）；N＋EN组患者ICU时间、误吸率显著低于S＋EN组患者（均P〈0．05）。N＋EN组、S＋EN组和TPN组重型颅脑损伤患者治疗前的PA、ALB、TP、IgG、IgA和IgM差异无统计学意义（均P〉0．05），治疗后三组患者PA、ALB、TP、IgG、IgA和IgM较治疗前显著增加（均P〈0．05），N＋EN组、S＋EN组和TPN组重型颅脑损伤患者治疗后的PA、ALB、TP、IgG、IgA和IgM均依次降低（均P〈0．05）。结论经鼻空肠营养管肠内营养治疗重型颅脑损伤患者疗效佳，并发症少，其疗效及安全性高于经胃管肠内营养和全肠外营养。

Objective To study the efficacy and safety of enteral nutrition by nasal jejunum nutrient canal on severe head injury patient. Methods Patients with severe head injury were divided into enteral nutrition by nasal jejunum nutrient canal group （N＋EN group）, nasogastric tube group （S＋EN group） and total parenteral nutrition group （TPN group）. The differences of curative effects, PA, ALB, TP, IgG, IgA and IgM were compared. Results The ICU hospitalization time, mortality and out-lung infection in N＋EN group and S＋EN group were significantly lower than in TPN group （P 〈 0.05）. The ICU hospitalization time and mis-aspiration rate in N＋EN group were significantly lower than those in S＋EN group （P 〈 0.05）. The post-therapy PA, ALB, TP, IgG, IgA and IgM in N＋EN group were significantly higher than those in S＋EN group （P 〈 0.05）. Conclusion Enteral nutrition by nasal jejunum nutrient canal on severe head injury patient has good curative effects and safety, which is better than nasogastric tube and total parenteral nutrition.