两种不同营养方式在重型颅脑损伤治疗中的疗效比较

doi:10.3969/j.issn.1002-1949.2019.01.006

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摘要目的探讨早期经皮内镜下胃、空肠造瘘术（PEG-J）在重型颅脑损伤（SHI）治疗中的临床价值及疗效。方法将我科2012年1月至2017年12月应用PEG-J营养治疗SHI 40例（PEG-J组）与经鼻胃肠管营养治疗SHI 30例（经鼻胃肠管组）的临床资料进行回顾性分析。比较两组行肠内营养后第1、21天非瘫痪侧的肱三头肌皮褶厚度(TSF)，体质量指数（BMI），血清白蛋白(Alb)，血红蛋白（Hb），胃肠道功能障碍（胃肠内容物潴留、呕吐、反流、腹泻、便秘），并发症（主要观察吸入性肺炎、消化道出血），住院时间以及格拉斯哥预后评分（GOS）等。结果 PEG-J组第21天人体测量指标、血液指标［TSF（11.58±1.38）mm、BMI（20.51±1.50）kg/m 2、Alb（40.98±4.41）g/L、Hb（113.68±21.68）g/L］均优于经鼻胃肠管组［TSF（10.78±1.72）mm、BMI(19.13±1.60)kg/m2、Alb（35.00±2.36）g/L、Hb （96.37±16.24）g/L，P＜0.05］；PEG-J组的胃肠道功能障碍明显少于经鼻胃肠管组（P＜0.05）； PEG-J组的并发症(10例 vs. 26例)、住院时间少于经鼻胃肠管组［(23.28±1.66)d vs.（27.67±2.09）d］（P＜0.05）；PEG-J组的GOS评分优于经鼻胃肠管组（P＜0.05）。结论 PEG-J是一种安全、有效、并发症少的手术，可以为SHI患者的营养支持提供最佳方法。

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	李乾锋
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关键词 ：重型颅脑损伤（SHI）, 经皮内镜下胃、空肠造瘘术（PEG-J）, 经鼻胃肠管营养, 治疗效果

通讯作者: 段发亮（1973-），男，博士，副主任医师， E-mail: duanfaliang@126.com。

作者简介: 李乾锋（1987-），男，硕士，主治医师，E-mail: qianfengli2007@126.com。

引用本文:

李乾锋，黄乔春，黄从刚，陈晓斌，吴京雷，段发亮. 两种不同营养方式在重型颅脑损伤治疗中的疗效比较[J]. 中国急救医学, 2019, 39(1): 29-33.
Li Qian-feng, Huang Qiao-chun, Huang Cong-gang, Chen Xiao-bin, Wu Jing-lei, Duan Fa-liang. The efficacy of two different nutritional methods in treatment of severe head injury. Chinese Journal of Critical Care Medicine, 2019, 39(1): 29-33.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.01.006 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I1/29

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