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特重型颅脑损伤肠外肠内的序贯营养支持 被引量:4

Sequent use of total parenteral nutrition and enteral nutrition in patients with specially serious celebral injuries
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摘要 目的:探讨特重型颅脑损伤早期全肠外(TPN)营养逐步过渡为肠内营养支持的临床意义及合理性。方法:营养组:17例GCS≤5分特重型颅脑损伤病人伤后2天开始应用TPN,6~7天后根据病情逐渐给予部分肠内营养(EN)过渡,10天后改为完全的EN。观察血糖、白蛋白、淋巴细胞计数、并发症发生率及预后。对照组:常规治疗的20例特重型颅脑损伤作对照。结果:特重型颅脑损伤病人能从早期的TPN中获得较充分的能量和蛋白质合成物,1周时的血糖控制程度、血浆白蛋白及外周血淋巴细胞总数优于对照组(P<0.05)。1周后逐渐过渡至EN更符合机体的生理要求,能保护肠粘膜屏障,使并发症减少。营养组1周后死亡率为29%,明显低于对照组(65%)(P<0.05)。结论:肠外、肠内序贯营养支持符合特重型颅脑损伤病人的病理、生理要求,能使该类病人营养状况和生存率提高。 Objectives:To investigate the clinical significance of sequent use of total parenteral nutrition(TPN) and enteral nutrition(EN) in patients with specially serious celebral injuries. Methods:17 cases of specially serious celebral injuries with GCS≤5 were given TPN for about one week and gradually changed to EN.Blood glucose,albumin,peripheral blood lymphocyte count,complication and outcome were observed.20 cases of specially serious celebral injuries who had been treated traditionally were regarded as control. Results:Blood glucose,albumin,total number of peripheral blood lymphocyteell count in parenteral nutrition support group by one week were significantly better than those in control group( P <0.05).Complication rate and mortality in nutritional support group was 26 percent,significantly lower than those in control group. Conclusions:Sequent nutritional support can decrease complication rate and increase survival rate in patients with specially serious celebral injury.
出处 《肠外与肠内营养》 CAS 1999年第2期82-84,共3页 Parenteral & Enteral Nutrition
基金 萧山市科协科研基金
关键词 特重型 颅脑损伤 序贯营养支持 Specially serious Celebral injury TPN EN Sequent nutritional support
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