摘要
目的探讨早期肠内营养(EEN)支持联合颅内压(ICP)监测在重型颅脑损伤(sTBI)患者中的应用效果及对预后的影响。方法选取2022年1月至2023年12月南京医科大学第一附属医院收治的120例sTBI患者,根据信封法将其随机划分为EEN组和对照组,各60例。对照组予以常规肠内营养支持联合ICP监测治疗,EEN组予以EEN支持联合ICP监测治疗,比较两组患者治疗前后营养学指标[血红蛋白(Hb)、前白蛋白(PA)和白蛋白(ALB)水平]、免疫功能指标[免疫球蛋白(Ig)A、IgG和IgM水平]、临床指标[ICU入住时间、总住院时间]、并发症及90 d病死率。结果两组治疗后Hb、PA、ALB、IgA、IgG和IgM水平均高于治疗前,且EEN组高于对照组(P<0.05)。EEN组ICU入住时间和总住院时间均少于对照组(P<0.05)。EEN组患者并发症总发生率低于对照组(P<0.05)。两组患者病死率比较,无统计学差异(P>0.05)。结论将EEN支持联合ICP监测应用于sTBI患者可有效改善其营养状态和免疫功能,缩短患者住院时间,减少并发症,且并未显著增加病死率,具有良好的应用价值。
Objective To investigate the application effect of early enteral nutrition(EEN)support combined with intracranial pressure(ICP)monitoring in patients with severe traumatic brain injury(sTBI)and its impact on prognosis.Methods A total of 120 patients with sTBI admitted to the hospital from January 2022 to December 2023 were selected.Using the envelope method,they were randomly assigned to the EEN group and the control group,with 60 cases in each group.The control group was given routine enteral nutrition support combined with ICP monitoring,while the EEN group was given EEN support combined with ICP monitoring.The two groups were compared on nutritional indicators[hemoglobin(Hb),prealbumin(PA)and albumin(ALB)],immune function indicators[immunoglobulin(Ig)A,IgG and IgM],clinical indicators(length of ICU stay and total length of hospital stay),complications,and 90-day mortality rate.Results After treatment,the levels of Hb,PA,ALB,IgA,IgG and IgM in both groups were higher than those before treatment.Moreover,the levels in EEN group were higher than those in the control group(P<0.05).The length of ICU stay and total length of hospital stay in EEN group were shorter compared to the control group(P<0.05).The total incidence of complications in EEN group was lower than that in the control group(P<0.05).There was no statistical difference in mortality rate between the two groups of patients(P>0.05).Conclusions Applying EEN support combined with ICP monitoring to patients with sTBI has good application values as it can effectively improve their nutritional status and immune function,shorten hospital stay,reduce complications and maintain a less significant increase in mortality rate.
作者
张程
许彬
毕立清
李娜
杨林
侯慧
徐修鹏
童孜蓉
ZHANG Cheng;XU Bin;BI Liqing;LI Na;YANG Lin;HOU Hui;XU Xiupeng;TONG Zirong(Neurosurgery ICU,the First Affiliated Hospital with Nanjing Medical University/Jiangsu Provincial People's Hospital,Nanjing,Jiangsu 210029,China)
出处
《中华神经外科疾病研究杂志》
2025年第3期119-123,共5页
Chinese Journal of Neurosurgical Disease Research
基金
国家自然科学基金项目(82203767)
江苏省科技项目(BK20201077)。
关键词
早期肠内营养支持
颅内压监测
重型颅脑损伤
应用
预后
Early enteral nutrition support
Intracranial pressure monitoring
Severe traumatic brain injury
Application
Prognosis
