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目的观察重型颅脑损伤术后不同营养方式对颅内感染的影响。方法将两家医院2001年1月-2009年10月收治的符合条件的326例重型颅脑损伤病例,术后1周内按营养方式不同分组。术后48 h内肠内营养(enteral nu-trition,EN)治疗组182例(EN组);术后肠外营养(parenteral nutrition,PN)治疗组144例(PN组)。观察两组术后颅内感染发生率和抗生素使用平均时间。结果两组病例术前年龄、性别、GCS评分比较差异无统计学意义(P>0.05);术后EN组颅内感染率6.05%,PN组颅内感染率18.75%。两组感染率比较差异有统计学意义(P<0.05);EN、PN组抗生素使用时间分别为(5.02±0.48)d、(8.35±1.71)d,两组抗生素使用时间比较,EN组抗生素使用时间明显缩短(P<0.05)。结论术后早期、规范的EN,是降低重型颅脑损伤术后颅内感染的重要措施之一。
Objective To observe the effect of different nutrition modes on intracranial infection after severe craniocerebral injury. Methods A total of 326 cases of severe traumatic brain injury in our hospital from January 2001 to October 2009 were enrolled in this study. The patients were divided into groups according to their nutritional status within 1 week after operation. 182 cases (EN group) were treated with enteral nu-trition (EN) within 48 hours and 144 cases (PN group) with parenteral nutrition (PN) after operation. The incidence of postoperative intracranial infection and the average duration of antibiotics use were observed. Results There was no significant difference in preoperative age, sex and GCS scores between the two groups (P> 0.05). The intracranial infection rate was 6.05% in EN group and 18.75% in PN group. The infection rates of the two groups were significantly different (P <0.05). The antibiotic use time in EN and PN groups were (5.02 ± 0.48) d and (8.35 ± 1.71) d respectively. The time was significantly shorter (P <0.05). Conclusion Early postoperative standard EN is one of the important measures to reduce intracranial infection after severe craniocerebral injury.