早期肠内营养对重度颅脑损伤患者治疗效果的影响

Effect of Early Enteral Nutrition in the Treatment of Severe Craniocerebral Injury

目的:研究早期肠内营养对重度颅脑损伤患者治疗效果的影响。方法:随机选取本院2016年3月-2017年10月收治的重度颅脑损伤患者共80例,按照随机数字表法分为研究组和对照组,每组40例。对照组实施全肠外营养,研究组实施早期肠内营养,对比分析两组GCS评分、基本循环功能指标、肺部感染、免疫功能及生存率。结果:两组第1、7天GCS评分比较,差异均无统计学意义(P>0.05),第30天研究组GCS评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后研究组心率(HR)、平均肺动脉压(MAP)、中心静脉压(CVP)等基本循环功能指标均明显优于对照组,差异均有统计学意义(P<0.05)。两组患者肺部感染随着时间的增加感染例数也随之增加,但治疗第1、3天两组肺部感染例数比较,差异均无统计学意义(P>0.05);第30天对照组肺部感染例数明显多于研究组,差异有统计学意义(P<0.05)。治疗后研究组免疫功能与对照组相比,差异无统计学意义(P>0.05)。两组治疗第1天生存率比较,差异无统计学意义(P>0.05),治疗第7、30天研究组生存率均明显高于对照组,差异均有统计学意义(P<0.05)。结论:早期肠内营养能够更好地治疗重度颅脑损伤患者,帮助患者尽早恢复健康,具有较高的临床应用价值。

Objective:To analyze the effect of early enteral nutrition in the treatment of severe craniocerebral injury.Method:A total of 80 patients with severe craniocerebral injury were randomly selected in our hospital from March 2016 to October 2017 and randomly divided into the study group and the control group,40 cases in each group.The control group was given total parenteral nutrition and the study group was given early enteral nutrition.GCS score,basic circulatory function index,pulmonary infection,immune function and survival rate of two groups were compared.Result:There were no significant differences in GCS score between two groups on the first and seventh day(P>0.05).However,GCS score of the study group on the 30th days after treatment was significantly higher than that of the control group(P<0.05).The basic circulatory function indexes such as heart rate(HR),mean pulmonary artery pressure(MAP),and central venous pressure(CVP)of the study group after treatment were significantly better than those of the control group,the differences were statistically significant(P<0.05).The number of pulmonary infections in the study group and the control group also increased with the increase of time,but the number of pulmonary infections in the first,third day of treatment of two groups were compared,the differences were not statistically significant(P>0.05).The number of pulmonary infection on the 30th day in the control group were significantly higher than that in the study group,and the difference was statistically significant(P<0.05).After treatment,the immune function of two groups,there was no statistically significant(P>0.05).There was no significant difference in the first day survival rate between two groups(P>0.05).The survival rate in the study group on the 7th,30th day were significantly higher than those in the control group,the difference were statistically significant(P<0.05).Conclusion:Early enteral nutrition can better treat severe craniocerebral injury,and help patients recover as soon as possible,it has a high clinical value.