|本期目录/Table of Contents|

[1]魏中南,张庆江,马 骁,等.小儿重型颅脑损伤早期肠内营养支持临床疗效观察[J].天津医科大学学报,2019,25(03):279-281.
 WEI Zhong-nan,ZHANG Qing-jiang,MA Xiao,et al.Clinical observation of early enteral nutrition support in children with severe craniocerebral injury[J].Journal of Tianjin Medical University,2019,25(03):279-281.
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小儿重型颅脑损伤早期肠内营养支持临床疗效观察(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
25卷
期数:
2019年03期
页码:
279-281
栏目:
临床医学
出版日期:
2019-05-20

文章信息/Info

Title:
Clinical observation of early enteral nutrition support in children with severe craniocerebral injury
文章编号:
1006-8147(2019)03-0279-03
作者:
魏中南张庆江马 骁孙 宁
(天津市儿童医院神经外科,天津300134)
Author(s):
WEI Zhong-nan ZHANG Qing-jiang MA Xiao SUN Ning
(Department of Neurosurgery, Tianjin Children’s Hospital, Tianjin 300134, China)
关键词:
重型颅脑损伤小儿早期肠内营养营养指标预后
Keywords:
severe traumatic brain injury children early enteral nutrition nutritional indicators prognosis
分类号:
R651.1+5
DOI:
-
文献标志码:
A
摘要:
目的:探讨早期肠内营养支持对重型颅脑损伤患儿的临床疗效。方法:选取2015年1月—2018年6月我院收治的重型颅脑损伤患儿96例作为研究资料,使用雀巢小百肽经鼻空肠管给予患儿营养支持,于肠内营养(EN)前、肠内营养1周后、肠内营养4周后分别采血分析营养指标水平,测量患儿体质量,上臂肌围。观察本组预后情况及胃肠道不良反应发生情况。结果:本组96例患儿,经过治疗及相关护理、肠内营养支持后,82例恢复良好,7例致残,2例植物生存,5例死亡。患儿经肠内营养支持后1周,除血红蛋白(Hb)外,血清白蛋白(ALB)、血清总蛋白(TP)、体质量、上臂肌围与肠内营养支持前无显著性差异(P>0.05),肠内营养支持4周后,ALB、TP、Hb、体质量、上臂肌围等水平均高于肠内营养支持前,差异显著(P<0.05)。结论:早期肠内营养支持应用于小儿重型颅脑损伤患儿,可迅速扭转机体负氮平衡,提高患儿营养水平,保护消化道功能,安全性高,并发症少,有利于疾病康复,对患儿预后具有积极意义。
Abstract:
Objective: To investigate the clinical effect of early enteral nutrition support on children with severe traumatic brain injury. Methods:Ninety-six children with severe traumatic brain injury admitted to our hospital from January 2015 to June 2018 were selected as the research subjects. Nestle Peptamen Junior was used to provide nutritional support through nose/jejunum tube. Blood samples were collected before enteral nutrition(EN), one week after enteral nutrition and four weeks after enteral nutrition to analyze nutritional indicators, and to measure the body weight and upper arm muscle circumference of the children. The prognosis and adverse reactions of gastrointestinal tract were observed. Results:After treatment, nursing and enteral nutrition support, 82 cases recovered well, 7 cases were disabled, 2 cases survived and 5 cases were passed. One week after enteral nutrition support, except for hemoglobin (Hb), there were no significant differences in serum albumin (ALB), total serum protein(TP), body weight, upper arm muscle circumference than before enteral nutrition support(P > 0.05). Four weeks after enteral nutrition support, the levels of ALB, TP, Hb, body weight and upper arm muscle circumference were higher than before enteral nutrition support(P < 0.05). Conclusion:Early enteral nutrition support in children with severe traumatic brain injury can quickly reverse negative nitrogen balance, improve nutritional level, protect digestive tract function, with high safety and fewer complications. It is crucial for to disease rehabilitation and has positive significance for the prognosis of children.

参考文献/References:

[1] 黄博婷, 林丹. 小儿重型颅脑损伤临床特点及护理干预[J]. 中国实用医药, 2016, 11(29): 273
[2] 只达石, 刘暌. 颅脑创伤外科学[M]. 北京: 人民卫生出版社, 2009:12
[3] 陈中俊, 刘文广, 左建东, 等. 早期肠内营养支持在重型颅脑损伤患者的应用[J]. 江苏医药, 2016, 42(4): 482
[4] Sulivan P G, Geriger J D, Mattson M P, et a1. Dietary supplement creatine protects against traumatic brain injury[J]. Ann Neurol, 2000, 48(5): 723
[5] 安玉玲, 熊亮, 刘剑戎, 等. 鼻肠管肠内营养在重型颅脑损伤患者中的作用[J]. 中国脑血管病杂志, 2016, 13(3):128
[6] 吕鉴峰, 赵红宇. 儿童颅脑外伤的诊治原则[J]. 中国小儿急救医学, 2016, 23(11):746
[7] 黄明火, 张正洪. 经鼻胃管早期规范化肠内营养对颅脑损伤患者的影响[J]. 广东医学, 2016, 37(6): 888
[8] 黎介寿. 肠内营养与肠屏障功能[J]. 肠外与肠内营养, 2016, 23(5): 257
[9] Cohen J E, Rajz G, Itshayek E, et a1. Bilateral acute epidural hematoma aftere vacuation of acute subdural hematoma: brain shift and the dynamics of extra axial collection[J]. Ncurol Res, 2014, 26(7): 763
[10] 许峰, 党红星. 危重症早期肠内营养的治疗进展[J]. 中国小儿急救医学, 2015, 22(2): 86
[11] 张赤, 王焱林, 杜朝晖,等. ICU颅脑损伤患者应用不同肠内营养及益生菌制剂的临床效果[J]. 武汉大学学报(医学版), 2017, 38(2): 283
[12] 曹丽芬, 吴海峰, 朱淑萍, 等. 综合护理干预在重症颅脑损伤肠内营养患者的应用[J]. 江苏医药, 2016, 42(13): 1469
[13] 谭敏, 段军伟, 彭华,等. 益生菌对重型颅脑损伤患者肠内营养耐受性的影响[J]. 川北医学院学报, 2014, 29(6): 567
[14] Mentec H, DuPont H, Bocchetti M, et a1. Upper digestive intolerance during eternal nutrition in critically Ⅲ patients: frequency, risk factors, and complications[J]. Crit Care Med, 200l, 29(10): 1955
[15] 夏晓华, 倪春华, 刘龙, 等. 经鼻空肠营养管在重型颅脑损伤肠内营养中的有效性和安全性[J]. 中国血液流变学杂志, 2015, 16(2): 167
[16] Mazaherpur S, Khatony A, Abdi A, et a1. The effect of continuous enteral nutrition on nutrition indices, compared to the intermittent and combination enteral nutrition in traumatic brain injury patients[J]. J Clin Diagn Res, 2016, 10(10): JC01
[17] 蒋建红, 刘文明, 周杰, 等. 早期肠内营养对重症颅脑损伤患者胃肠道功能的影响[J]. 中国急救复苏与灾害医学杂志, 2015, 22(5):435
[18] 吴春涛, 王凤安. 早期肠内营养在重型颅脑损伤患者急性胃肠损伤中的应用[J]. 中华临床营养杂志, 2016, 24(5): 274

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备注/Memo

备注/Memo:
作者简介 魏中南(1981-),男,主治医师,硕士,研究方向:小儿神经外科;E-mail: weizhongnantj@163.com。
更新日期/Last Update: 2019-07-03