肠内外序贯营养支持对重症颅脑损伤患者肠黏膜屏障的影响

Effect of Sequential Enteral and Parenteral Nutrition Support on the Intestinal Mucosal Barrier in Patients with Severe Craniocerebral Injury

目的研究分析肠内外序贯营养支持应用于重症颅脑损伤患者肠黏膜屏障的临床效果。方法整群选取2012年12月—2014年12月该院收治的重症颅脑损伤患者76例,随机分为对照组、观察组,每组38例。对照组采用单纯肠内营养支持,观察组采用肠内外序贯营养支持,比较分析两组营养支持前后谷氨酰胺、白蛋白水平、甘露醇/乳果糖(L/M)变化情况以及并发症发生率和预后效果。结果观察组营养支持10 d后谷氨酰胺和白蛋白水平显著高于对照组,差异有统计学意义(P<0.05);观察组营养支持10 d后L/M显著低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率和死亡率显著低于对照组,差异有统计学意义(P<0.05)。结论对于重症颅脑损伤患者肠黏膜屏障给予肠内外序贯营养支持具有较高的临床应用效果,能够显著改善患者机体营养,减少并发症,降低死亡率,值得推广。

Objective To study and analyze the clinical effect of sequential enteral and parenteral nutrition support on the intestinal mucosal barrier in patients with severe craniocerebral injury. Methods 76 cases with severe craniocerebral injury admitted in our hospital from December 2012 to December 2014 were selected and randomized into the control group and the observation group with 38 cases in each. Simple enteral nutrition support was applied to the control group, sequential enteral and parenteral nutrition support was given to the observation group. The glutamine level, albumin level, lactulose /mannitol（L/M） before and after nutrition support, incidence of complications and prognosis were compared and analyzed between the two groups. Results After 10 d of nutrition support, the glutamine level and albumin level was much higher in the observation group than that in the control group respectively with statistically significant difference（P〈0.05）. The L/M was much lower in the observation group than that in the control group after 10 d of nutrition support with statistically significant difference（P〈0.05）. The incidence of complications and mortality was significantly lower in the observation group than that in the control group, respectively, the difference was statistically significant（P〈0.05）. Conclusion For severe craniocerebral injury patients, sequential enteral and parenteral nutrition support has higher clinical application effect, which can significantly improve the nutrition of the body, reduce the incidence of complications and the mortality, therefore it is worthy of promotion.