摘要
目的：通过检测相关急性时相反应蛋白C-反应蛋白（CRP）在体液中的微观改变，探讨重型颅脑损伤患者早期肠内营养对保护肠道黏膜、减轻全身炎症反应的作用。方法：选择我院2007年1月～2008年3月30例重型颅脑损伤住院患者作为研究对象，随机分为早期肠内营养（EEN）组15例，早期胃肠外营养（PN）组15例。入院48h内予不同方法的营养支持。分别测定入院后3h及伤后或术后第1天、第4天、第7天、第14天血清中CRP的含量。结果：EEN组与PN组两组CRP含量在伤后3h内差异无统计学意义（P〉0．05）。随时间变化两组CRP浓度均呈下降趋势，但EEN组下降幅度明显。EEN组与PN组CRP含量在伤后第1天分别为（60．50±6．31）mg／L、（60．82±5．82）mg／L，两组比较差异无统计学意义（P〉0．05），伤后第4天、第7天、第14天EEN组CRP含量分别为（50．22±5．02）mg／L、（34．49±4．17）mg／L、（13．68±1．76）mg／L，PN组CRP分别为（53．88±0．04）mg／L、（42．08±3．20）mg／L、（19．11±3．17）mg／L，两组比较差异有统计学意义（P〈0．05，P〈0．01，P〈0．01）。EEN组伤后第14天格拉斯哥昏迷评分（GCS）高于PN组，两组比较差异有统计学意义（P〈0．05）。结论：重型颅脑损伤后早期肠内营养支持可起到保护胃肠道黏膜、降低全身炎症反应的作用。
Objective ：To study how early enteral nutrition can protect intestinal tract mucous membrane and reduce the whole body inflammatory response by observing microscopic changes of related acute phase response protein CRP in the body fluid after early administration of enteral nutrition to patients with severe cranioeerebral injury. Methods：Thirty patients with severe eraniocerebral injury admitted in our hospital during Jan 2007 - Mar 2008 were randomly divided into two groups as early enteral nutrition （EEN） group（ 15 cases） and early parenteral nutrition（PN） group（ 15 cases） ,who were given different nutrition support within 48 hours after admission. The serum CRP concentration of all cases were determined On the zero,the first, the fourth,the seventh and the fourteenth day respectively after injury. Results：The difference in CRP contents in EEN group and PN group in 3 h after injury showed no statistical significanee（P 〉0.05）,but with the time change,the concentration levels of the two groups dropped with that of EEN group more obviously. CRP contents of the two groups at the same time point in 1 st d after injury （ 60. 50 ± 6. 31 ） mg/L, （ 60. 82 ± 5.82） mg/L showed no statistical significance （ P 〉 0.05 ）. CRP plasma level of EEN group was（ 50. 22 ± 5.02 ） mg/L,lower than that of PN group（ P 〈 0.05 ） in 4th d after injury. CRP plasma level of EEN group was obviously lower than that of the PN group （ P 〈 0.01 ） at the same time point in 7th d （34.49 ± 4. 17） mg/L and 14th d（ 13.68 ± 1.76） mg/L. CRP levels of PN group were （53.88 ± 0.04） mg/L, （42. 08 ± 3.20 ） mg/L, （ 19. 11 ± 3.17 ） mg/L respectively with statistical significance （ P 〈 0.05, P 〈 0.01, P 〈 0.01 ）. The GCS grading in EEN was higher than that of PN group （ P 〈 0.05 ） in 14th d after injury. Conclusion：After severe craniocerebral injury,enteral nutrition support in early time may play a role in protecting gastro-intestinal tract mucous membrane and reducing the whole body inflammatory response. If the gastro-intestinal tract function permits, early enteral nutrition should be considered as the first option.
出处
《临床误诊误治》
2008年第12期6-9,共4页
Clinical Misdiagnosis & Mistherapy
关键词
肠道营养
胃肠外营养
颅脑损伤
C-反应蛋白
Enteral nutrition
Parenteral nutrition
Cranioeerebral injury
C-reactive protein
