重症脑外科患者术后肠内营养支持的治疗效果

Therapeutic effect of postoperative enteral nutrition to severe brain-injured patients

目的探讨重症脑外科患者术后肠内营养支持的治疗效果。方法选取荣昌区人民医院2014年1月至2015年6月术后给予肠内营养支持的46例重症脑外科患者作为观察组,选取该院2012年1月至2013年9月术后未给予肠内营养支持的45例重症脑外科患者作为对照组,对两组患者的临床病例资料进行回顾性分析,查阅和测量患者术前1 d,术后第1、3天,术后第1、2周的中性粒细胞百分比、白细胞和红细胞计数及血红蛋白水平。观察术前1 d、术后第1、2周血清清蛋白、前清蛋白水平,并分析术后并发症发生情况。结果术后第1、3天,术后第1、2周4个时间点,观察组患者的白细胞计数、中性粒细胞百分比显著低于对照组,差异均有统计学意义(P<0.05);观察组患者的血红蛋白水平、红细胞计数均显著高于对照组,差异均有统计学意义(P<0.05)。术后第1、2周前清蛋白水平高于对照组,差异有统计学意义(P<0.05);观察组患者的血清清蛋白水平与对照组比较,差异无统计学意义(P>0.05)。术后2周,观察组并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论肠内营养是一种无创性、简单、易行的营养支持方式,术后尽早给予患者肠内营养支持,可有效降低感染发生率,提高临床治疗效果,促使患者早日康复。

Objective To investigate the therapeutic effect of postoperative enteral nutrition to severe brain-injured patients. Methods A total of 46 severe brain-injured patients with postoperative enteral nutrition support from January 2014 to June 2015 in People ′s Hospital of Rongchang District were selected as the observation group,while 45 severe brain-injured patients without enteral nutrition in the hospital from January 2012 to September 2013 were selected as the control group. The clini-cal data of the patients in the two groups was analyzed retrospectively;the quantities of neutrophils,white blood cell, hemoglobin and red blood cell were inspected and detected on 1 d before operation and 1st day,2nd day,1st week,3rd week after operation.The levels of serum albumin and prealbumin on 1 d before operation and 1st week,2nd week after operation were observed, while the postoperative complications were analyzed. Results On the 1st day,3rd day,1st week and 2nd week after operation, the proportions of white blood cell and neutrophils in the observation group were obviously lower than those in the control group with statistically significant difference（P〈0.05）,while the levels of hemoglobin, red blood cell and prealbumin in the observation group were remarkably higher than those in the control group with statistically significant difference（P〈0.05）;however,the difference of serum albumin between the two groups had no statistical significance（P〈0.05）. The occurrence rate of postoperative complications on 2 weeks after operation in the observation group was prominently lower than that in the control group, and the difference showed statistical significant difference（P〈0.05）. Conclusion Enteral nutrition is a noninvasive,simple and easy method of nutritional support,early postoperative enteral nutrition can effectively reduce the incidence of infection,improve the clinical treatment effect and make a quick recovery for patients.