早期胃肠营养对脑外伤昏迷患者氮代谢及胃肠道功能的影响

The Effect of Early Gastrointestinal Nutrition on Nitrogen Metabolism and Gastrointestinal Function in Coma Patients with Cerebral Trauma

目的:探讨早期胃肠营养对脑外伤昏迷患者氮代谢和胃肠道功能的影响。方法:选择2019年1月—2023年1月常熟市中医院收治的80例脑外伤昏迷患者,按1∶1的比例随机分为对照组和观察组,各40例。对照组接受常规营养支持,观察组在创伤后早期接受特定的胃肠营养支持。对两组氮代谢相关指标、营养指标、胃肠道功能、免疫功能指标及并发症总发生率进行评估。结果:干预7 d后,观察组氮代谢改善更显著,胃排空时间、胃肠道激素水平等胃肠道功能相关指标均优于对照组,IgG、IgA、CD4^(+)T细胞及CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P<0.05)。此外,观察组的并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:早期胃肠营养支持可以改善脑外伤昏迷患者的氮代谢、胃肠道功能和免疫功能,有助于促进患者的康复,降低并发症的风险。

Objective:To investigate the effects of early gastrointestinal nutrition on nitrogen metabolism and gastrointestinal function in coma patients with cerebral trauma.Method:A total of 80 coma patients with cerebral trauma admitted to Changshu Traditional Chinese Medicine Hospital from January 2019 to January 2023were selected and randomly divided into the control group and the observation group,according to the ratio of 1∶1,with 40 cases in each group.The control group received routine nutritional support,while the observation group received specific early gastrointestinal nutrition support.The nitrogen metabolism indicators,nutritional indicators,gastrointestinal function,immune function indicators,and the total incidence of complications were evaluated in the two groups.Result:After 7 days of intervention,the improvement of nitrogen metabolism in the observation group was more significant,the gastric emptying time,gastrointestinal hormone levels and other gastrointestinal function-related indicators were better than those in the control group,the IgG,IgA,CD4^(+)T cells and CD4^(+)/CD8^(+) were higher than those in the control group,the differences were statistically significant(P<0.05).In addition,the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Early gastrointestinal nutritional support can improve nitrogen metabolism,gastrointestinal function,and immune function in coma patients with cerebral trauma,which is helpful to promote the recovery of patients and reduce the risk of complications.