经鼻空肠管早期肠内营养在重型颅脑损伤患者中的应用价值

目的研究经鼻空肠管在重型颅脑损伤患者早期肠内营养支持中的应用价值,以提高重型颅脑损伤患者的救治效果。方法把2009年1月~2013年12月期间实施早期肠内营养支持的重型颅脑损伤患者320例随机分为实验组和对照组,实验组120例应用鼻空肠管,对照组200例应用鼻胃管,观察两组患者肠内营养支持效果及死亡率、并发症状况。结果置管14天后,实验组格拉斯哥(GCS)昏迷评分为(7.5士1.1)分,对照组为(6.8士1.2)分,差异有统计学意义(P0.05)。置管前与置管14天后两组患者血清总蛋白(TP)、前白蛋自(PA)、血红蛋自(Hb)差异有统计学意义(P0.05),表明实验组营养支持更有效。实验组发生误吸4例、反流8例、腹泻22例、消化道出血13例、肺感染14例,对照组发生误吸38例、反流45例、腹泻42例、胃潴留24例、消化道出血27例、肺感染59例,并发症差异均有统计学意义(P0.05)。实验组死亡率19.8%,对照组死亡率为33.4%,两组间有统计学差异(P0.05)。结论经鼻空肠管早期肠内营养对重型颅脑损伤患者营养支持作用好,可明显减少并发症,提高生存率。

Clinical application of early jejunum tube in enteral nutrition support of craniocerebral injury patients

Objective To study the nasal jejunal tube in patients with severe craniocerebral injury the application value of early enteral nutrition support,in order to improve the treatment effect of patients with severe craniocerebral injury.Methods In January 2009 to December 2013,the implementation of early enteral nutrition support of 320 cases of severe craniocerebral injury patients were randomly divided into experimental group and control group,experimental group120 cases of nasal jejunal tube,the control group,200 cases of nasal gastric tube,observe the effect of two groups of patients with enteral nutrition support and the status of the mortality and morbidity.Results Catheter after 14 days,Glasgow coma scale of trial group（7.5士 1.1）,the control group（6.8士1.2）,scale was statistically difference between the two groups（P〈0.05）.Tube and catheter after 14 days before the two groups of patients with serum total eggs from the door（TP）,a former white eggs（PA）,the blood of eggs（Hb）difference was statistically significant（P〈0.05）,indicating that group more effective nutrition support.Experimental group 4cases of aspiration,reflux,8cases,22 cases of diarrhea,abdominal distension,13 cases of gastrointestinal bleeding,pulmonary infection in 14 cases,control group of 38 cases of aspiration,45 cases of reflux,42 cases of diarrhea,gastric retention 24 cases,27cases of gastrointestinal bleeding,pulmonary infection,59 patients,complications were statistically significant difference（P〈0.05）.Mortality by 19.8%,while control group is 33.4%,mortality was statistically difference between the two groups（P〈0.05）.Conclusion Nasal jejunal tube early enteral nutrition nutrition support in patients with severe head injury effect is good,can obviously reduce the complications and improve the survival rate.