序贯营养支持法在重度颅脑损伤代谢紊乱患者治疗中的应用
营养,,序贯营养支持法；,重度颅脑损伤；,血糖；,白蛋白；,淋巴细胞计数,1资料与方法,2结果,3讨论,参考文献：
摘要： 目的： 探讨重度颅脑损伤患者治疗早期实行肠内、肠外序贯营养支持(TPN)法的合理性和临床效果。方法： 实验组37例重度颅脑损伤患者在常规治疗基础上早期给予TPN，入院2～3 d给予肠外营养(PN),2～8 d后给予肠内营养(EN)+PN，5 d后给予EN。对照组33例重度颅脑损伤患者常规治疗同治疗组,EN采用混合奶，经胃管给予。观察第1、7、14、21天2组血糖、血清白蛋白水平和外周血淋巴细胞计数。结果： 2组血糖水平均随时间推移逐渐降低，第1、7、14、21天实验组与对照组比较差异无统计学意义(P>0.05)；第21天实验组血清白蛋白水平明显高于对照组(P<0.05)；第14、21天实验组淋巴细胞计数明显高于对照组(P<0.05)。结论： 重度颅脑损伤早期行TPN能逐渐满足机体所需能量及氮的需求，通过较短时间肠外、肠内给予营养的过渡，并尽早实行EN更符合机体的生理需求，保护肠粘膜屏障，减少感染和并发症的发生,TPN符合颅脑损伤患者的病理、生理改变，能逐渐改变此类患者的营养状况。关键词： 序贯营养支持法； 重度颅脑损伤； 血糖； 白蛋白； 淋巴细胞计数
Application of procedural nutrition therapy during treatment on serious craniocerebral injury
ZHANG Jinghua， Liu Peng
(Department of ICU, Fifth Affiliated Hospital, Xinjiang Medical University, Urumqi 830011, China)
Abstract: Objective: To study the feasibility and clinical effect of early applying enteral or parenteral nutrition on serious craniocerebral injury. Methods: Procedural nutrition therapy was used on 37 cases. The patients blood sugar, albumin and the number of lymphocyte were observed. Thirtythree patients of the control group were selected, which were treated by enteral nutrition. Results: The level of blood sugar in two groups decreased with the increase of days. Statistic revealed there were no changes between two groups in the same time. The level of albumin in two groups increased with the increase of days. Statistic revealed there were significant changes between two groups in 21 day. The number of lymphocyte in two groups increased with the increase of days. Statistic revealed there were significant changes between two groups in 14 and 21 day. Coclusions: Early applying total parenteral nutrition adapts to the need of nutrition on patients. Intestine mucosa barrier is protected, and complication decreases. Procedural nutrition therapy is adapted to the change of pathophysiology and used to improve the situation in nutrition on patients. ......
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