重度颅脑损伤后不同营养支持途径合理性的临床评价
作者：张建军 宣宏飞 顾水均 谢仁龙 张俊 来谊
单位：311200 浙扛萧山第一人民医院神经外科(张建军、宜宏飞、顾水均、谢仁龙、张俊)，PN配制室(来谊)
关键词：重度颅脑损伤；营养支持
中国临床营养杂志000103摘 要：目的评价重度颅脑损伤后早期不同营养支持途径的合理性及临床意义。方法将GCS≤8分的重度颅脑损伤患者随机分成A组(肠外、肠内序贯营养支持组)、B组(单纯肠外营养组，PN)、C组(单纯肠内营养组，EN)，每组28例。伤后48～72小时给予不同的营养支持，观察各组营养状态的变化及早、晚期并发症的发生率和预后。结果伤后1周时，A、B组血清总蛋白、白蛋白、血红蛋白等指标优于C组，早期并发症少于C组(P<0.05)。2周时三组上述指标虽略有高低，统计学差异无显著性(P>0.05)，但B、C组的并发症高于A组(P<0.05)。按QCS预后评定A组预后优于B、C两组(P<0.05)，死亡率A组最低。结论重度颅脑损伤后早期肠外、一周后过渡至肠内营养支持是较为合理的营养支持途径。
, 百拇医药
Clinical evaluation of rationality of nutrition support in the cases of serious cerebral injuries
ZHANG Jianjun ,XIAN Hongfei ,GU Shuijun
(Department of Neurosurgery, Xiaoshan First People' Hospital, Zhejiang 311200)
Abstract：Objective To evaluate rationality and clinical significant of different nutrition surpport in the cases of serious cerebral injuries. Mothods The cases of serious cerebral injuries, whose GCS≤8, were divided randomly into 3 groups. While group A (PN to EN sequently) ,group B(PN only) ,group C(EN only) ,each group had 28 cases. They were given different nutrition support in 48～72 hours after injury. The change of blood glucose, blood electrolyte, blood total protein, blood albumin with blood hemoglobin was observed. At same time, we observed the complication and prognosis of early stage and late stage. Results One week late after injury, total serum protein, albumin, hemoglobin and the other indicators of group A and group B are better than these of group C, and the complication of group A and group B is less than those of group C (P<0.05). Two weeks later, although the indicators of 3 groups are similar and there is no statistical significant difference (group A. The prognosis of group A is better than that of group B and group C, depending on prognosis evaluation, and group A had the lowest mortality rate. Conelusions To the prognosis,rational nutrition support had very important clinical significant. PN at early stage and changing from PN-EN in one week is rational nutrition support.
, http://www.100md.com
Keywords：Serious cerebral injury Nutrition support
参考文献：
[1]Clifton GL, Ronertson C, Choi S. Assessment of nutritional equiremnts of head-injuried patients. J Neurosurg, 1986, 64: 895-898.
[2]王任直，连玮，任祖渊，等.急性神经损伤和疾病的经肠营养.肠外与肠内营养，1998，5：40-43.
[3]Youg B, Ott L, Haack D, et al. Effect of total pareneral nutrition upon intracranial pressure in severe head injury. J Neurosurg, 1987, 67: 75-77.
, http://www.100md.com
[4]王之敏，惠国桢.早期胃肠外营养对重症脑外伤及氮代谢的影响.中华神经外科杂志.1995，11：344-347.
[5]李宁，黎介寿.肠道营养重要性的认识.肠外与肠内营养，1998，5：1-2.
[6]Bengmark S, Jppsson B. Gastrointestinal surface protection and mucosa reconditioning. JPEN, 1995, 19: 410-414.
收稿日期：1999-01-04
修稿日期：1999-11-07, 百拇医药
单位：311200 浙扛萧山第一人民医院神经外科(张建军、宜宏飞、顾水均、谢仁龙、张俊)，PN配制室(来谊)
关键词：重度颅脑损伤；营养支持
中国临床营养杂志000103摘 要：目的评价重度颅脑损伤后早期不同营养支持途径的合理性及临床意义。方法将GCS≤8分的重度颅脑损伤患者随机分成A组(肠外、肠内序贯营养支持组)、B组(单纯肠外营养组，PN)、C组(单纯肠内营养组，EN)，每组28例。伤后48～72小时给予不同的营养支持，观察各组营养状态的变化及早、晚期并发症的发生率和预后。结果伤后1周时，A、B组血清总蛋白、白蛋白、血红蛋白等指标优于C组，早期并发症少于C组(P<0.05)。2周时三组上述指标虽略有高低，统计学差异无显著性(P>0.05)，但B、C组的并发症高于A组(P<0.05)。按QCS预后评定A组预后优于B、C两组(P<0.05)，死亡率A组最低。结论重度颅脑损伤后早期肠外、一周后过渡至肠内营养支持是较为合理的营养支持途径。
, 百拇医药
Clinical evaluation of rationality of nutrition support in the cases of serious cerebral injuries
ZHANG Jianjun ,XIAN Hongfei ,GU Shuijun
(Department of Neurosurgery, Xiaoshan First People' Hospital, Zhejiang 311200)
Abstract：Objective To evaluate rationality and clinical significant of different nutrition surpport in the cases of serious cerebral injuries. Mothods The cases of serious cerebral injuries, whose GCS≤8, were divided randomly into 3 groups. While group A (PN to EN sequently) ,group B(PN only) ,group C(EN only) ,each group had 28 cases. They were given different nutrition support in 48～72 hours after injury. The change of blood glucose, blood electrolyte, blood total protein, blood albumin with blood hemoglobin was observed. At same time, we observed the complication and prognosis of early stage and late stage. Results One week late after injury, total serum protein, albumin, hemoglobin and the other indicators of group A and group B are better than these of group C, and the complication of group A and group B is less than those of group C (P<0.05). Two weeks later, although the indicators of 3 groups are similar and there is no statistical significant difference (group A. The prognosis of group A is better than that of group B and group C, depending on prognosis evaluation, and group A had the lowest mortality rate. Conelusions To the prognosis,rational nutrition support had very important clinical significant. PN at early stage and changing from PN-EN in one week is rational nutrition support.
, http://www.100md.com
Keywords：Serious cerebral injury Nutrition support
参考文献：
[1]Clifton GL, Ronertson C, Choi S. Assessment of nutritional equiremnts of head-injuried patients. J Neurosurg, 1986, 64: 895-898.
[2]王任直，连玮，任祖渊，等.急性神经损伤和疾病的经肠营养.肠外与肠内营养，1998，5：40-43.
[3]Youg B, Ott L, Haack D, et al. Effect of total pareneral nutrition upon intracranial pressure in severe head injury. J Neurosurg, 1987, 67: 75-77.
, http://www.100md.com
[4]王之敏，惠国桢.早期胃肠外营养对重症脑外伤及氮代谢的影响.中华神经外科杂志.1995，11：344-347.
[5]李宁，黎介寿.肠道营养重要性的认识.肠外与肠内营养，1998，5：1-2.
[6]Bengmark S, Jppsson B. Gastrointestinal surface protection and mucosa reconditioning. JPEN, 1995, 19: 410-414.
收稿日期：1999-01-04
修稿日期：1999-11-07, 百拇医药