鼻肠管肠内营养在神经外科昏迷患者营养支持中的应用

Application of enteral nutrition via nasointestinal tube in the nutrition support of narcose patients in department of neurosurgery

目的探讨鼻肠管肠内营养在神经外科昏迷患者营养支持中的应用效果。方法选取神经外科手术昏迷患者78例,随机分为鼻胃管组与鼻肠管组。鼻胃管组给予鼻胃管肠内营养,鼻肠管组给予鼻肠管肠内营养,比较2组治疗前、治疗后14 d血清白蛋白(Alb)、血红蛋白(Hb)、血清前白蛋白(PAB)水平和并发症发生率。结果治疗后14 d,2组Alb、Hb、PAB水平均较治疗前明显升高(P<0.05或P<0.01),且鼻肠管组改善程度明显优于鼻胃管组(P<0.01)。鼻肠管组并发症总发生率明显低于鼻胃管组(P<0.01);2组误吸和返流发生率比较差异有统计学意义(P<0.05)。结论神经外科昏迷患者经鼻肠管给予肠内营养治疗,能明显改善患者营养状况。

Objective To investigate the application value of enteral nutrition via nasointes- tinal tube in the nutrition support of narcose patients in department of neurosurgery. Methods Totally 78 narcose patients underwent surgery in department of neurosurgery were selected and randomly divided into nasogastric tube group treated with enteral nutrition via nasogastric tube and nasointestinal tube group treated with enteral nutrition via nasointestinal tube. The levels of serum albumin （Alb） , hemoglobin （Hb） and prealbumin （PAB） as well as incidence rate of complications were compared between two groups before and 14 d after treatment. Results Fourteen days after treatment, the levels of Alb, Hb and PAB in two groups increased significantly when compared with pre-treatment （P 〈 0.05 or P 〈0.01 ）, and the improvement degree in nasointestinal tube group was superior to that in nasogastric tube group （ P 〈 0.01 ）. The incidence rate of total complications in nasointestinal tube group was significantly lower than that in nasogastric tube group （ P 〈 0.01 ）. There was significant difference between two groups in the incidence rate of aspiration and reflux （ P 〈 0.05 ）. Conclusion For narcose patients in department of neurosurgery, application of enteral nutrition via nasointestihal tube can effectively ameliorate the nutritional status of patients.