The Benefits of Early Jejunal Hyperalimentation in the Head-Injured Patient
The Benefits of Early Jejunal Hyperalimentation in the Head-Injured Patient
复制标题
早期空肠高营养对头部受伤患者的好处
DOI：
10.1097/00006123-198911000-00007
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发表时间：
1989
期刊：
影响因子：
4.8
通讯作者：
T. Harrington
中科院分区：
文献类型：
--
作者：
T. Grahm;D. Zadrozny;T. Harrington
为了确定早期空肠高营养作为颅脑损伤患者营养支持的效果，我们对32例格拉斯哥昏迷评分低于10分的颅脑损伤患者进行了伤后7天的研究。实验组(E)在透视下放置鼻空肠饲管。在受伤的36小时内，他们接受的营养支持等于他们测量的静息能量消耗。当肠音恢复时，对照组(C)给予胃喂养。两组患者在年龄、格拉斯哥昏迷评分、神经损伤类型及相关损伤方面差异均无统计学意义（P > 0.05）。两组的平均静息能量消耗、血清白蛋白、葡萄糖、淋巴细胞计数、体重和总氮损失几乎相同。空肠喂养改善了日热量（E = 2102 kcal vs C = 1100 kcal）、氮摄入量（E = 11.1 g vs C = 5.6 g）和日氮平衡（E = -4.3 g vs C = -11.8 g）。细菌感染发生率（E = 3 vs C = 14）和重症监护病房住院天数（E = 6 vs C = 10）显著减少（P < 0.05）。头部受伤的患者可以忍受早期的空肠高营养，尽管临床表现为无症状的腹部，并且可以避免全肠外营养的成本和并发症。增加热量和氮的摄入，改善氮潴留，显著减少感染和在重症监护病房的住院天数。
To determine the efficacy of early jejunal hyperalimentation as nutritional support in the head-injured patient, 32 head-injured patients with Glasgow Coma Scale scores less than 10 were studied for the first 7 days after injury. The experimental (E) group had nasojejunal feeding tubes placed fluoroscopically. Within 36 hours of injury, they received nutritional support equal to their measured resting energy expenditure. The control (C) group was fed gastrically when bowel sounds returned. There were no significant differences (P greater than 0.05) in age, Glasgow Coma Scale score, type of neurological injury, or associated injuries between the two groups. The mean resting energy expenditure, serum albumin, glucose, lymphocyte count, body weight, and total nitrogen loss were nearly identical for both groups. With the jejunal feedings, daily caloric (E = 2102 kcal versus C = 1100 kcal) and nitrogen intake (E = 11.1 g versus C = 5.6 g) and daily nitrogen balance (E = -4.3 g versus C = -11.8 g) improved. The incidence of bacterial infections (E = 3 versus C = 14) and days of intensive care unit hospitalization (E = 6 versus C = 10) were significantly reduced (P less than .05). Head-injured patients will tolerate early jejunal hyperalimentation despite the presence of a clinically silent abdomen, and the cost and complications of total parenteral nutrition are avoided. The increased caloric and nitrogen intake and improved nitrogen retention markedly reduced infections and days of stay in the intensive care unit.