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早期营养支持在神经外科昏迷患者中的应用

Application of Early Nutrition Support in Neurosurgical Coma Patients.

作者信息

Ren Guoqin

机构信息

Wuxi Second Hospital Affiliated to Nanjing Medical University, No. 68 Zhongshan Road, Wuxi, 214002 China.

出版信息

Indian J Surg. 2015 Dec;77(Suppl 3):1205-8. doi: 10.1007/s12262-015-1250-7. Epub 2015 Mar 17.

Abstract

The present study was conducted to investigate the clinical efficacy of early parenteral and enteral nutrition (PN + EN) support in neurosurgical coma patients. Eighty cases of neurosurgical coma patients were randomly divided into intervention group and control group. The intervention group received early PN + EN support, and the control group received only total enteral nutritional (TEN) support. The levels of hemoglobin (HGB), serum albumin (ALB), prealbumin (PA), and retinol-binding protein (RBP) in two groups on days 1, 10, and 20 were observed. The incidences of pneumonia, stress ulcer, abnormal liver function, abdominal distension, and diarrhea between two groups were also compared. Results found that, on day 10, compared with the control group, the levels of HGB, PA, and RBP in the intervention group were significantly increased (P < 0.05). On day 20, ALB in the intervention group significantly increased (P < 0.05), and the incidences of pneumonia, abdominal distension, and diarrhea in the intervention group were significantly lower than those in the control group (P < 0.05). Compared with only TEN support, early PN + EN support can obviously improve the nutritional status of neurosurgical coma patients and reduce the occurrence of complications.

摘要

本研究旨在探讨早期肠外与肠内营养(PN + EN)支持对神经外科昏迷患者的临床疗效。80例神经外科昏迷患者随机分为干预组和对照组。干预组接受早期PN + EN支持,对照组仅接受全肠内营养(TEN)支持。观察两组在第1天、第10天和第20天的血红蛋白(HGB)、血清白蛋白(ALB)、前白蛋白(PA)和视黄醇结合蛋白(RBP)水平。比较两组肺炎、应激性溃疡、肝功能异常、腹胀和腹泻的发生率。结果发现,在第10天,与对照组相比,干预组的HGB、PA和RBP水平显著升高(P < 0.05)。在第20天,干预组的ALB显著升高(P < 0.05),且干预组肺炎、腹胀和腹泻的发生率显著低于对照组(P < 0.05)。与仅TEN支持相比,早期PN + EN支持可明显改善神经外科昏迷患者的营养状况并减少并发症的发生。

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