摘要
目的探讨早期营养支持对儿童重型颅脑外伤患者重症监护室(ICU)治疗时间及预后的影响。方法选取ICU重型颅脑外伤患儿80例,回顾性分析其临床资料,全部患儿均接受早期营养支持,对营养支持方式、开始时间和达到完全热量摄入的时间进行记录,并对早期营养支持和患儿ICU治疗时间及预后的相关性展开分析。结果本组未实施营养支持前即发生死亡的患儿共有8例,72例患儿入住ICU后开始营养支持的时间为(1.50±0.71)d,达到完全热量摄入的时间为(3.41±0.55)d,ICU治疗时间为(2.12±0.58)d;其中64例(88.89%)患儿接受肠内营养,3例(4.17%)患儿接受肠外营养,5例(6.94%)患儿接受肠内、肠外联合营养;出院时本组患儿中38例(52.78%)患儿按照改良儿童脑功能分级量表(PCPC)分级恢复正常,23例(31.94%)患儿残疾,11例(15.28%)患儿昏迷或死亡;营养支持开始时间、达到完全热量摄入时间和ICU治疗时间表现为正相关(P<0.05)。结论开展早期营养支持与重型颅脑损伤患儿ICU治疗时间相关联,且早期开展营养支持,患儿预后效果较好。
Objective To explore the effect of early nutritional support on the treatment time and prognosis of children with severe craniocerebral trauma in intensive care unit(ICU).Methods Eighty children with severe craniocerebral trauma in ICU were selected and their clinical data were retrospectively analyzed.All the children received early nutritional support.Nutritional support methods,starting time and time to complete calorie intake were recorded.The correlation between early nutritional support and treatment time and prognosis of ICU was analyzed.Results Eight children died before nutritional support was implemented in this group.The time of starting nutritional support was(1.50±0.71)days after admission to ICU,the time of reaching full calorie intake was(3.41±0.55)days,and the time of ICU treatment was(2.12±0.58)days.Of these,64(88.89%)received enteral nutrition,3(4.17%)received parenteral nutrition,and 5(6.94%)received parenteral nutrition.After combined enteral and parenteral nutrition,38(52.78%)of the discharged children had normal PCPC classification,23(31.94%)had disability and 11(15.28%)had coma or death.There was a positive correlation between the start time of nutritional support,the time of complete calorie intake and the time of ICU treatment(P<0.05).Conclusion The ICU treatment time of children with severe craniocerebral injury is related with early nutritional support,and good outcome for children is related to early nutritional support.
作者
彭爱英
张国庆
罗丹丹
肖娟
PENG Aiying;ZHANG Guoqing;LUO Dandan;XIAO Juan(ICU,Hunan Children's Hospital,410007)
基金
湖南省卫生计生委科研计划课题项目(C2016022)。
关键词
早期营养支持
儿童
重型颅脑损伤
重症监护室
预后
Prognosis of early nutritional support
Intensive care unit
Children
Severe craniocerebral injury
