摘要
目的探讨重型颅脑损伤术后不同营养方式对颅内感染影响,以期降低颅内感染的临床发生率,提高医疗质量。方法随机选取2011年2月-2013年1月100例重型颅脑损伤患者为研究对象,对其中的颅内感染病例根据不同的营养方式分成两组,肠内营养组于术后48h后给予肠内营养,肠外营养组予以肠外营养,观察两组术后颅内感染的相关情况。结果肠内营养组在术后第1、4、7、15天的白细胞、淋巴细胞计数和C-反应蛋白分别比肠外营养组患者高,组间每个时间段比较,差异均有统计学意义(P<0.05);肠内营养组患者在ICU的住院天数(6.38±5.6)d、抗菌药物使用天数(7.4±4.3)d、SIRS发生0例、GCS评分(12.5±3.3)分、SOFA评分(2.93±2.18)分、APACHEⅡ评分(9.38±7.13)分、病死率2.0%、并发症发生率4.0%;肠外营养组上述指标分别为(12.5±8.2)d、(13.8±7.9)d、4.0%、(9.1±0.4)分、(2.72±4.72)分、(5.48±5.13)分、6.0%、18.0%,组间比较差异均有统计学意义(P<0.05)。结论重型颅脑损伤术后早期进行规范的肠内营养可促进感染的恢复,提高临床效果。
OBJECTIVE To study the effects of different nutrition modes on the intracranial infections in severe brain injury patients so as to reduce the incidence of intracranial infections and improve the medical quality. METHODS A total of 100cases of severe craniocerebral injury,who were treated in the hospital from Feb 2011to Jan 2013,were enrolled in the study,then the subjects with the intracranial infections were divided into two groups according to the nutrition mode,the enteral nutrition group was given with the enteral nutrition 48hours after the surgery,while the parenteral nutrition group was treated with the parenteral nutrition,and the incidence of postoperative intracranial infections was observed and compared between the two groups.RESULTS The leukocyte counts,lymphocyte counts,and level of C-reactive protein at 1,4,7,15days after the surgery were significantly higher in the enteral nutrition group than in the parenteral nutrition group,the differences were significant（P0.05）.The length of ICU stay was（6.38±5.6）days in the enteral nutrition group,（12.5±8.2）days in the parenteral nutrition group;the duration of use of antibiotic was（7.4±4.3）days in the enteral nutrition group,（13.8±7.9）days in the parenteral nutrition group;the incidence of SIRS was 0 in the enteral nutrition group, 4.0% in the parenteral nutrition group;the GCS score was（12.5±3.3）points in the enteral nutrition group,（9.1±0.4）points in the parenteral nutrition group;the SOFA score was（2.93±2.18）points in the enteral nutrition group,（2.72±4.72）points in the parenteral nutrition group;the APACHEⅡ score was（2.93±2.18） points in the enteral nutrition group,（5.48±5.13）points in the parenteral nutrition group;the mortality was 2.0% in the enteral nutrition group,6.0% in the parenteral nutrition group;the incidence of complications was 4.0% in the enteral nutrition group,18.0% in the parenteral nutrition group;the differences were significant（P 0.05）.CONCLUSIONTo perform the standardized enteral nutrition for the severe brain injury patients in early stage may facilitate recovery from the infections and improve the clinical effect.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第1期173-175,共3页
Chinese Journal of Nosocomiology
基金
济宁市卫生局基金项目(SJ-2009B-033)
关键词
重型颅脑损伤
肠内营养
肠外营养
颅内感染
Severe brain injury
Enteral nutrition
Parenteral nutrition
Intracranial infection
