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目的探讨经鼻营养支持对急性颅脑损伤后机体蛋白质代谢的影响。方法选取2013年7月至2015年7月中山市人民医院接诊的急性颅脑损伤患者300例。按随机数字表法分为对照组和观察组,各150例。观察组采用经鼻营养支持治疗,对照组采用常规静脉营养支持治疗。观察两组患者治疗前后胰岛素用量和血糖控制情况、治疗前后营养情况、胃肠道功能障碍情况、并发症发生率及临床疗效。结果治疗后,观察组胰岛素用量、空腹血糖、血糖达标时间均小于对照组[(31±9)U/d比(41±15)U/d,(5.2±1.3)mmol/L比(6.9±1.7)mmol/L,(6.4±1.2)d比(9.6±3.2)d]差异有统计学意义(P<0.01);观察组前白蛋白、血红蛋白、球蛋白均显著高于对照组[(227±48)mg/L比(188±41)mg/L,(112±17)g/L比(105±15)g/L,(25±4)g/L比(17±4)g/L],差异有统计学意义(P<0.01);观察组临床总有效率显著高于对照组[80.00%(120/150)比45.33%(68/150)](P<0.05);观察组胃肠道功能障碍总发生率显著低于观察组[35.33%(53/150)比78.00%(117/150)],差异有统计学意义(P<0.01);观察组并发症总发生率显著低于对照组[25.33%(38/150)比51.33%(77/150)],差异有统计学意义(P<0.01)。结论经鼻营养支持可以维持急性颅脑损伤后机体营养状况,蛋白质的流失可以得到有效的改善,代谢功能也能恢复正常,值得临床推广。
Objective To investigate the effect of nasal nutrition support on protein metabolism in acute traumatic brain injury. Methods From July 2013 to July 2015, Zhongshan People’s Hospital admitted 300 patients with acute craniocerebral injury. According to random number table divided into control group and observation group, 150 cases each. The observation group was treated with nasal nutrition support, while the control group was treated with routine intravenous nutrition support. Before and after treatment, insulin dosage and blood sugar control were observed. The nutritional status, gastrointestinal dysfunction, complication rate and clinical effect were observed before and after treatment. Results After treatment, the insulin dosage, fasting blood glucose and blood glucose in the observation group were all lower than those in the control group [(31 ± 9) U / d (41 ± 15) U / d and (5.2 ± 1.3) mmol / L) 1.7) mmol / L, (6.4 ± 1.2) d vs (9.6 ± 3.2) d] (P <0.01). The levels of albumin, hemoglobin and globulin in the observation group were significantly higher than those in the control group L to (48 ± 4) g / L (17 ± 4) g / L vs (188 ± 41) mg / L vs 112 ± 17 g / L vs 105 ± 15 g / (P <0.01). The total effective rate in the observation group was significantly higher than that in the control group (80.00% (120/150) vs 45.33% (68/150)] (P <0.05) The total incidence of gastrointestinal dysfunction was significantly lower than that of the observation group [35.33% (53/150) vs 78.00% (117/150)], the difference was statistically significant (P <0.01). The total incidence of complications in the observation group was significantly Lower than the control group [25.33% (38/150) vs 51.33% (77/150)], the difference was statistically significant (P <0.01). Conclusion Nasal nutrition support can maintain the nutritional status of acute traumatic brain injury, protein loss can be effectively improved, and metabolic function can return to normal, worthy of clinical promotion.