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肠内联合肠外营养可改善颅脑损伤患者的临床结局。

Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury.

机构信息

Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China.

Department of Clinical Nutrition, Xianyang Central Hospital, Xianyang, People's Republic of China.

出版信息

Nutr Neurosci. 2022 Mar;25(3):530-536. doi: 10.1080/1028415X.2020.1765114. Epub 2020 May 20.

Abstract

: To investigate the effect of nutritional support on nutritional status and clinical outcomes of patients with traumatic brain injury (TBI).: Sixty-one patients with TBI from the intensive care unit and neurosurgery of Xianyang Central Hospital from 2017 to 2019 were retrospectively included. General and clinical data of the study subjects were collected. The control group ( = 28) received parenteral nutrition alone, and the observation group ( = 33) received parenteral nutrition combined with enteral nutrition. The general conditions and biochemical indicators of both groups of patients were divided into two groups of ≤8 and ≥9 for stratified analysis to compare the nutritional support status and infection complications during hospitalization Occurrence, ICU length of stay, total length of stay, total cost of stay, and prognostic indicators of the patients were analyzed and compared.: There were no significant differences in biochemical indicators between both groups of patients when they were discharged. Among patients with GCS ≤8 points, the incidence of lung infection in the observer was significantly higher than that in the control group ( < 0.001), but the incidence of intracranial infection, stress ulcers, and diarrhea was not statistically different from that in the control group ( = 0.739). No significant differences were observed in hospitalization time and hospitalization costs between both groups ( = 0.306 and = 0.079, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score ( = 0.042 and  = 0.025, respectively). When GCS was ≥ 9 points, there was no statistical difference in the incidence of lung infections and intracranial infections between both groups of patients ( = 0.800 and  = 0.127, respectively). The observation group was significantly higher than the control group in terms of length of hospital stay, nasal feeding time and hospitalization costs ( < 0.001,  < 0.001 and  = 0.006, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score ( = 0.001 and  = 0.015, respectively). There was no significant difference in the incidence of pulmonary infection and intracranial infection between both groups of patients ( = 0.800 and  = 0.127, respectively).: Enteral nutrition combined with parenteral nutrition intervention has a positive effect on the clinical prognosis of TBI patients.

摘要

目的

探讨营养支持对创伤性脑损伤(TBI)患者营养状况及临床结局的影响。

方法

选取 2017 年至 2019 年咸阳市中心医院重症监护病房和神经外科收治的 61 例 TBI 患者进行回顾性研究。收集研究对象的一般资料和临床资料。对照组(n=28)给予单纯肠外营养,观察组(n=33)给予肠外营养联合肠内营养。对两组患者的一般情况和生化指标进行分层分析,比较两组患者的营养支持状况及住院期间感染并发症的发生情况、入住重症监护病房(ICU)时间、总住院时间、总住院费用及患者预后指标。

结果

两组患者出院时生化指标无明显差异。GCS≤8 分患者中,观察组肺部感染发生率明显高于对照组(<0.001),但颅内感染、应激性溃疡、腹泻发生率与对照组比较差异无统计学意义(=0.739)。两组患者住院时间和住院费用比较差异无统计学意义(=0.306 和=0.079)。观察组 GCS 评分和远期生活质量评分明显优于对照组(=0.042 和=0.025)。GCS≥9 分患者肺部感染和颅内感染发生率两组间比较差异无统计学意义(=0.800 和=0.127)。观察组患者住院时间、鼻饲时间及住院费用明显低于对照组(<0.001、<0.001 和=0.006)。观察组 GCS 评分和远期生活质量评分明显优于对照组(=0.001 和=0.015)。两组患者肺部感染和颅内感染发生率比较差异无统计学意义(=0.800 和=0.127)。

结论

肠内营养联合肠外营养干预对 TBI 患者的临床预后有积极影响。

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