肠内营养支持治疗在神经科昏迷病人中的应用

THE EFFECT OF ENTERAL NUTRITION FOR NEUROLOGICAL PATIENTS IN COMA

①目的 了解不同肠内营养支持治疗方法对神经科昏迷病人的效果。②方法 昏迷病人 48例 ,随机分为安素组 (n =2 5)和混合奶组 (n =2 3) ,分别经鼻胃管连续重力滴注安素和一次投给混合奶 ,测定营养支持治疗前 1d和营养支持治疗第 1 4天肱三头肌皮褶厚度 (TSF)及血清清蛋白 (Alb)、前清蛋白 (PA)、血红蛋白 (Hb)含量。③结果 安素组TSF、Alb和PA营养支持治疗后均明显高于营养支持治疗前 (t =- 2 .62 0～ 4 .90 8,P <0 .0 5) ,Hb营养支持治疗前后差异无显著性 (t=0 .2 66 ,P >0 .0 5) ;混合奶组TSF、PA和Hb营养支持治疗前后差异无显著性 (t=0 .50 0～ 1 .389,P >0 .0 5) ,Alb在营养支持治疗后明显低于营养支持治疗前 (t=3 .790 ,P <0 .0 0 1 )。营养支持治疗后安素组TSF和Alb均明显高于混合奶组 ,差异有显著性 (t=2 .0 39、2 .570 ,P <0 .0 5) ,而PA和Hb差异无显著性 (t=1 .60 8、0 .966 ,P >0 .0 5)。

Objective\ To investigate the effect of supportive enteral nutrition for neurological patients in coma. \ Methods Forty eight patients in coma were randomly divided into Ensure Group and Mixed milk Group. The former was administered enteral feeding of Ensure, and the latter, mixed milk was given. Triceps skinfold thickness(TSF), serum albumin(Alb), prealbumin(PA) and hemoglobin(Hb) were measured 1 day before and 14 days after the treatment.\ Results\ In Ensure Group, TSF, Alb and PA were dramatically higher after the treatment compared with before treatment ( t=2.620-4.908, P <0.05), and Hb showed no significance ( t=0.266, P >0.05). For Mixed milk Group, TSF, PA and Hb were found no significance before and after the treatment ( t=0.500-1.389, P >0.05), Alb was significantly lower than that before treatment ( t=3.790, P <0.001). After the treatment, TSF and Alb of Ensure Group were significantly higher than that of Mixed milk Group ( t=2.039, 2.570, P < 0.05), while the differences of PA and Hb were not significant ( t=1.608, 0.966, P > 0.05 ).\ Conclusion\ A continuous dripping of Ensure through nasogastric tube for patients in coma is an effective supportive measure for enteral nutrition.