摘要
目的:观察早期肠内营养(enteral nutrition,EN)干预对重症脑外伤患者神经功能、营养状况及炎症应激反应的影响。方法:本研究为单中心前瞻性研究,按照信封抽签法将68例重症脑外伤患者分为对照组[接受肠外营养(parenteral nutrition,PN)干预,n=34]和观察组(接受早期EN干预,n=34)。对比两组神经功能改善情况[血清中枢神经特异性(serum central nervous system specific,S100β)蛋白、美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分、髓鞘碱性蛋白(myelin basic protein,MBP)]、营养状况[转铁蛋白(transferrin,TRF)、总蛋白(total protein,TP)、白蛋白(albumin,ALB)和前白蛋白(prealbumin,PA)]、炎症应激指标[C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、谷胱甘肽氧化物酶(glutathione peroxidase,GSH-PX)、丙二醛(malondialdehyde,MDA)]、日常生活活动能力、生活质量及并发症发生情况。结果:与对照组干预后相比,观察组NIHSS评分、S100β蛋白、MBP、CRP、PCT、MDA更低,TRF、TP、ALB、PA、GSH-PX、改良Barthel指数、世界卫生组织生活质量评定量表-100(world health organization quality of life assessment scale-100,WHOQOL-100)量表评分更高(P<0.05)。两组并发症发生率组间对比未见差异(P>0.05)。结论:重症脑外伤患者采用早期EN干预可有效改善神经功能、营养状况,减轻机体炎症应激反应,值得临床借鉴应用。
Objective:To observe the effects of early enteral nutrition(EN)intervention on neurological function,nutritional status,and inflammatory stress response in patients with severe traumatic brain injury.Methods:This study was a single-center prospective study,68 patients with severe traumatic brain injury were divided into control group[received parenteral nutrition(PN)intervention,n=34]and observation group(received early EN intervention,n=34)according to the envelope lottery method.The improvement of neurological function[serum central nervous system specific(S100β)protein,national institutes of health stroke scale(NIHSS)score,myelin basic protein(MBP)],nutritional status[transferrin(TRF),total protein(TP),albumin(ALB)and prealbumin(PA)],inflammatory stress indicators[C-reactive protein(CRP),procalcitonin(PCT),glutathione peroxidase(GSH-PX),malondialdehyde(MDA)],daily living activity ability,quality of life,and incidence of complications between two groups were compared.Results:Compared with the control group after intervention,the observation group had lower NIHSS scores,S100βprotein,MBP,CRP,PCT and MDA,had higher TRF,TP,ALB,PA,GSH-PX,improved Barthel index and world health organization quality of life assessment scale-100(WHOQOL-100)score(P<0.05).There was no difference in the incidence of complications between the two groups(P>0.05).Conclusion:Early EN intervention in patients with severe traumatic brain injury can effectively improve neurological function,nutritional status,and reduce the body's inflammatory stress response,which is worthy of clinical reference and application.
作者
邱美玲
郭秋荫
蔡聪妮
QIU Mei-ling;GUO Qiu-yin;CAI Cong-ni(Department of Neurosurgery,Shishi Hospital,Quanzhou,Fujian,362700,China)
出处
《现代生物医学进展》
2025年第19期3154-3161,共8页
Progress in Modern Biomedicine
基金
泉州市科技计划项目(2020N083s)。
关键词
肠内营养
重症
脑外伤
神经功能
营养状况
炎症应激反应
Enteral nutrition
Severe
Traumatic brain injury
Neurological function
Nutritional status
Inflammatory stress response
