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肠内营养时机对老年重型颅脑疾病术后临床疗效的影响

刘瑞东   

  1. 天津市第三中心医院神经外科
  • 收稿日期:2014-04-11 修回日期:2014-06-26 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 刘瑞东

Effects of Enteral Nutrition on Clinical Curative Effect in Elderly Patients with Severe Craniocerebral Diseases

LIU Rui dong   

  1. Department of Neurosurgery, Tianjin Third Central Hospital
  • Received:2014-04-11 Revised:2014-06-26 Published:2014-11-15 Online:2014-11-15
  • Contact: LIU Rui dong

摘要:

摘要】 目的 研究老年重型颅脑疾病术后开始建立肠内营养的最佳时机。 方法 81 例老年重型颅脑疾病患者分为 ABC 组, 分别于手术后 24 h2548 h4972 h 开始建立肠内营养支持, 分别监测血清生化指标、并发症和 GCS 评分的变化。 结果 术后血清生化指标变化: B 组血清白蛋白及血红蛋白水平较 AC 组增高, AB 组淋巴细胞总数较 C 组明显增高(P0.05)。 并发症方面: 术后 7 dB 组腹泻发生比例少于 A (3.6% vs 26.9%), 应激性溃疡比例少于 C (0 vs 22.2%);术后 14 dB 组肺感染发生比例少于 A (10.7% vs 38.5%), 应激性溃疡比例少于 C
(3.6% vs 25.9%)。 术后 14 dB GCS 评分高于 AC (10.2±1.3 vs 9.5±1.2 vs 9.4±1.2,P0.05)结论 对老年重型颅脑疾病患者于手术后 2548 h 内开始给予肠内营养更能满足营养及代谢支持的需要, 减少并发症, 有利于患者意识水平的恢复。

关键词: 老年人, 颅脑损伤, 脑出血, 肠内营养

Abstract:

[Abstract]   Objective   To investigate the best time to establish the enteral nutrition (EN) in elderly patients with se?
vere craniocerebral diseases.   Methods   Eighty-one elderly patients were divided into groups A, B and C. The EN support  were given 24 h, 25-48 h, and 49-72 h after surgery. Changes of serum biochemical indexes, complications and GCS score were detected and statistical analysed.   Results   The serum levels of albumin and hemoglobin were significantly increased in group B than those of group A and group C. The total number of lymphocytes was significantly higher in group A and group B than that of group C (P0.05). The amount of diarrhea was significantly fewer 7-day after operation in group B than that of group A (3.6% vs 26.9%). The amount of stress ulcer was significantly fewer in group B than that of group C (0 vs 22.2%). The amounts of lung infections (10.7% vs 38.5%) and stress ulcer (3.6% vs 25.9%) were significantly fewer 14-day after operation in group B than those of group A. The scores of GCS were significantly higher 14-day after operation in group B than those of group A and group C (10.2±1.3 vs 9.5±1.2 vs 9.4±1.2, P0.05).   Conclusion   The establishment of EN support 25to 48 hours after surgery may meet the need of nutritional and metabolic support, reduce complications, be conducive to the
consciousness recovery in elderly patients with severe craniocerebral diseases.


Key words: Old people, brain injury, cerebral hemorrhage, enteral nutrition