[1]赵 杰,武 燕,陈 静,等.幽门后早期肠内营养在重型颅脑损伤病人中的应用[J].肠外与肠内营养杂志,2020,(04):235-239.[doi:DOI : 10.16151/j.1007-810x.2020.04.010]
 ZHAO Jie,WU Yan,CHEN Jing,et al.The Effects of Early Nasojejunal Enteral Nutrition in Patients with Severe Traumatic Brain Injury[J].PARENTERAL & ENTERAL NUTRITION,2020,(04):235-239.[doi:DOI : 10.16151/j.1007-810x.2020.04.010]
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幽门后早期肠内营养在重型颅脑损伤病人中的应用
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2020年04期
页码:
235-239
栏目:
论著
出版日期:
2020-07-10

文章信息/Info

Title:
The Effects of Early Nasojejunal Enteral Nutrition in Patients with Severe Traumatic Brain Injury
作者:
赵 杰武 燕陈 静祁 静
中国人民解放军东部战区总医院 解放军神经外科研究所,江苏南京210002
Author(s):
ZHAO Jie WU Yan CHEN Jing QI Jing
Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China
关键词:
肠内营养 重型颅脑损伤 幽门后喂养 胃内喂养
Keywords:
Enteral nutrition Severe traumatic brain injury Nasojejunal feeding Nasogastric feeding
分类号:
R459.3,R651.1+5
DOI:
DOI : 10.16151/j.1007-810x.2020.04.010
文献标志码:
A
摘要:
目的:本研究的目的是评估经幽门后喂养与经胃内喂养对重型颅脑损伤病人营养状况、喂养耐受性和其他不良预后的影响。 方法:纳入东部战区总医院神经外科 ICU从 2015年 1月至 2017年 12月收治的 151例重型脑外伤病人。所有病人分为两组:幽门后喂养组(73例)和胃内喂养组(78例)。主要观察指标:血液中相关营养指标和肠内营养(EN)喂养耐受性。次要观察指标:院内肺炎发生率、机械通气时间、ICU和住院时间、ICU和院内死亡率等指标。 结果:幽门后喂养组在第 14天白蛋白水平显著升高(P = 0.001)。幽门后喂养组前白蛋白和总蛋白水平分别在第 7天和第 14天显著升高(第 7天P = 0.01, P = 0.04,第 14天P = 0.001, P = 0.025)及视黄醇结合蛋白和转铁蛋白水平在第 7天也显著增加(第 7天 P = 0.017, P = 0.029)。同时,幽门后喂养与胃内喂养相比:热卡摄入量更高和较少的胃肠道并发症的发生率及降低肺炎发生率(P < 0.05)。其他观察指标两组间无显著性差异。 结论:相较于经胃内喂养,幽门后喂养可快速改善重型颅脑损伤病人的营养状况,减少胃肠道并发症和肺炎的发生。
Abstract:
Objective: The current study aimed to evaluate the effects of nasojejunal versus nasogastric feeding on nutrition status, feeding intolerance, and other clinical outcomes in patients with severe traumatic brain injury.Methods: One hundred and fifty-one patients with severe traumatic brain injury admitted to neurosurgical ICU in Jinling hospital from January 2015 to December 2017 were included in this study. The study patients were divided into nasojejunal feeding group (n = 73) or nasogastric feeding group (n = 78). The primary clinical outcomes were biochemical nutrition markers, and the incidence of feeding intolerance. Secondary clinical outcomes included the incidence of pneumonia, length of mechanical ventilation duration, lengths of ICU and hospital stay, ICU mortality as well as hospital mortality. Results: Patients in nasojejunal feeding group had significantly higher albumin levels at day14 (P = 0.001). Prealbumin and total protein levels were remarkably increased in nasojejunal feeding group in comparison with nasogastric feeding group at day 7 and 14, respectively (day7 P = 0.01, P = 0.040, day14 P = 0.001, P = 0.025). In addition, Patients in nasojejunal feeding group also had higher retinol binding protein and transferrin levels at day 7 (P = 0.017, P = 0.029). Furthermore, patients in nasojejunal feeding group received higher amounts of calories while had lower incidences of enteral nutrition-related gastrointestinal complications (P < 0.05) as well as a lower incidence of pneumonia (P < 0.05). There was no significant difference in other clinical outcomes. Conclusion: Compared to nasogastric feeding, enteral nutrition delivered through nasojejunal route showed greater effects in improving nutrition status and reducing the incidence of gastrointestinal complications as well as pneumonia in patients with severe traumatic brain injury.

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备注/Memo

备注/Memo:
作者简介 :赵 杰,护师,护理学本科,从事神经外科护理工作。E-mail:441938982@qq.com 通讯作者 :祁 静,E-mail:546176733@qq.com
更新日期/Last Update: 1900-01-01