螺旋型鼻肠管在颅脑损伤患者早期肠内营养支持中的应用

Effect of early enteral nutritional support with naso-enteric tube in cranial-cerebral injury patients

目的 探讨螺旋型鼻肠管在颅脑损伤患者早期肠内营养支持中的临床意义。方法 5 9例重型颅脑损伤患者随机分为 3组 ,A组 ( 18例 )采用经螺旋型鼻肠管进行早期肠内营养 (EN) +肠外营养 (PN) ;B组 ( 2 2例 )采用经鼻胃管进行早期EN +PN ;C组 ( 19例 )采用经鼻胃管进行早期PN EN的序贯营养方法 ,对 3组患者进行观察和分析。结果 3组患者血清蛋白均有不同程度提高 ,治疗后 14d ,A组血清白蛋白 (Alb)为 ( 3 2 .3 6± 4.72 ) g/L ,转铁蛋白 (TNF)为 ( 1.60± 0 .3 8) g/L ,前白蛋白 (PA)为 ( 178.2 2± 2 5 .63 )mg/L ;B组Alb为 ( 3 1.5 4± 3 .67) g/L ,TFN为 ( 1.5 9± 0 .2 2 ) g/L ,PA为 ( 174.63± 2 8.3 3 )mg/L ;C组Alb为 ( 3 0 .88± 2 .5 5 ) g/L ,TFN为 ( 1.5 9± 0 .2 9) g/L ,PA为 ( 171.85± 3 0 .62 )mg/L ;均较治疗前明显提高 (P <0 .0 5 )。结论 ①鼻肠管对提高颅脑损伤患者早期EN支持过程中的胃肠道耐受性及降低并发症有积极作用。②早期EN

Objective To discuss the effectiveness of early enteral nutritional support with naso-enteric tube in cranial-cerebral injury patients. Methods Group A, 18 cases, received early concomitent parenteral nutrition(PN) and enteral nutrition(EN) with spiral naso-enteric tube; group B, 22 cases, received early PN and EN together with naso-gastric tube; group C, 19 cases, received early PN, and EN after 1 week with naso-gastric tube. The clinical observation and statistical analysis were compared. Results The serum protein levels were improved in all three groups. As compared with the datas before given nutritional support, the levels of Alb, TFN and PA on day 14 in all three groups were all improved. The rate of gastroenteric intolerance and complications in group A were lower than that in group B and C. Conclusions ① Early enteral nutrition with naso-enteric tube can effectively improve gastroenteric tolerance and decrease the incidence of complication in cranial-cerebral injury patients. ② Early enteral nutritional support with EN and PN together may be the best way for cranial-cerebral injury patients.