[经典]早期肠内营养支持在重型颅脑损伤治疗中的效果.doc

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1、[经典]早期肠内营养支持在重型颅脑损伤治疗中的效果早期肠内营养支持在重型颅脑损伤治疗中的效果【摘要】目的探讨早期肠内营养支持在重型颅脑损伤治疗中的作用。方法将符合条件的患者随机分为治疗组和对照组，治疗组于伤后自第2天始胃管内给予10%GS100ml+美兰1支,观察4h后，尿内若有美兰染色，证明肠道有吸收功能，后给5%GNS500ml持续胃管内泵入，第3天给予百普利鼻饲500ml持续24h泵入，第4天加用能全力500ml持续24h泵入，逐渐增加肠内营养液，1周后达全量；期间胃肠外所需热量均由卡文供给。对照组于受伤2

2、d后予肠外营养支持，等肠鸣音出现后（5、7d）开始渐转为肠内营养。并观察两组血糖、血清总蛋白、谷丙转氨酶、淋巴细胞计数、血生化离子、肝功、肾功，同时观察各组并发症的发生率和预后。结果治疗组的营养指标明显优于对照组（P<0.05）,并发症低于对照组（P〈0.05）,预后良好。结论严重颅脑损伤早期肠内营养支持有利于脑损伤患者尽早康复。【关键词】早期肠内营养；重型颅脑损伤；治疗TheeffectofearlynutritioninthetreatmentofpatientswithsevereheadinjuryZHO

3、UXia,LTUDe-zhi.DepartmentofAnesthesiology,CentralHospitalofXinxiang,Xinxiang,453000,China[Abstract]ObjectiveToexploretheactionofearlynutritioninthetreatmentofpatientswithsevereheadinjury.MethodsTheeligiblepatientsweredividedintothetreatmentgroupandcontrolgrou

4、p,thetreatmentgroupfromtheseconddaysafterinjuryinthebeginningofgastrictubetogive10%GS100ml+MethyleneBlue,afterobserved4hours,itwasproofedtheintestinalabsorptionifMethyleneBluedyeintheurine,then5%GNS500mlwascontinedgastrictubeintothepump,thethirdday,continuedt

5、ogivepeptison500mlnasalpumplasting24h,thefourthdaywasaddedtothenutrisonfibre500mlcontined24hinfusion,andincreasingenteralnutrition,uptofullvolumeafteraweek.Duringthistime,caloriesgastrointestinaloutsidewassuppliedallbyKabivenbeginningafter36~48hinstalledgastr

6、ictube.Thepatientsofthecontrolgroupweregivenparenteralnutrition,thenwou1dbegintoenteralnutritiongraduallyafterbowelsoundappearsd(5-7hours).Weobservedtwogroupsbloodsugar,serumtotalprotein,cerealthirdtransaminase,lymph-cellcounts,bloodbiochemicalions,liver,kidn

7、ey,andobservedreactivegroupstheincidenceofcomplicationsandprognosis.ResultsThenutritionindexofthetreatmentgroupwasbetterthanthatofthecontrolgroups(P<0.05),complicationswaslowerthanthatofthecontrolgroup(P<0.05)andprognosiswasbetter.ConclusionEarlynutritioninth

8、etreatmentofpatientswithsevereheadinjuryishelpedforthebrain-damagedpatientsrecoveredassoonaspossible.[Keywords]Earlynurtrition;Severeheadinjury;Treatment重度颅脑损伤患者由于意识障碍、吞咽功能障碍无法正常进食，因此，对这类