CAJ | 학술논문

目的　研究早期肠道内营养（EN）在重型脑外伤患者治疗过程中的作用。方法　对30例重型脑外伤患者行早期肠道内营养，取同期的30例重型脑外伤患者行早期肠道外营养（PN），并动态观察其白蛋白、淋巴细胞数（LC）、谷草转氨酶（ALT）、血糖、颅内压（ICP）、哥拉斯哥评分（GCS）、体重、应激性溃疡发病率等变化。结果　伤后10天，EN组与PN组的白蛋白、LC、ICP、体重无显著差异（P＞0.05）,但伤后10天，EN组 ALT低于PN组，分别为(35±4.8)u/L，(38±4.2)u/L，（P＜0.0 5）；EN组血糖也低于PN组，分别为(8.4±3.4)mmol/L，(10.3±3.6)mmol/L，（P ＜0.05）；EN组GCS评分高于PN组，分别为(10.6±2.7)分,(8.9±2.6 )分,(P＜0.05)分；EN组应激性溃疡发病率低于PN组,分别为1 0%和33.3%（P＜0.05）。结论　早期肠道内营养与肠道外营养具有同样的营养价值，但在调节内脏功能、降低血糖、保护肝脏、降低应激性溃疡的发病率、促进神经功能恢复等方面明显优于肠道外营养。
목적　연구조기장도내영양（EN）재 중형뇌외상환자치료과정중적작용。방법　대30례중형뇌외상환자행조기 장도내영양，취동기적30례중형뇌외상환자행조기장도외영양（PN），병동태관찰기백단백 、림파세포수（LC）、곡초전안매（ALT）、혈당、로내압（ICP）、가랍사가평분（GCS）、체중、응격성궤양발병솔등변화。결과　상후10천，EN조여PN조적백단 백、LC、ICP、체중무현저차이（P＞0.05）,단상후10천，EN조 ALT저우PN조，분별위(35±4.8)u/L，(38±4.2)u/L，（P＜0.0 5）；EN조혈당야저우PN조，분별위(8.4±3.4)mmol/L，(10.3±3.6)mmol/L，（P ＜0.05）；EN조GCS평분고우PN조，분별위(10.6±2.7)분,(8.9±2.6 )분,(P＜0.05)분；EN조응격성궤양발병솔저우PN조,분별위1 0%화33.3%（P＜0.05）。결론　조기장도 내영양여장도외영양구유동양적영양개치，단재조절내장공능、강저혈당、보호간장、강저 응격성궤양적발병솔、촉진신경공능회복등방면명현우우장도외영양。
Objective　To investigate the effects of early enteral nutrition in the severe head injured patients.Methods 　The 60 patients with GCS of 5 to 8 were randomly divided into two groups:30 p atients with enteral nutrition(EN),the others with parenteral nutrition(PN) .In both groups,the serum albumin and glucose levels,lymphocyte count,ALT,GCS,bo dy's weight and the rate of stress ulcer were observed 2,5,8 and 10 days post he ad injury.Results　The serum albumin levels,lymphocyt e count,ICP and body's weight,showed no signifitcant difference in both groups w ithin 10 days after head injury,but in EN group,the ALT(35±4.8 u/l),the serum g lucose (8.4±3.4mmol/l) and the rate of stress ulcer(10%) were all signifitively lower than that of the PN group (38±4.2u/l,10.3±3.6mmol/l,33%),the GCS in EN group(10.6±2.7) was higher than that in PN group(8.9±2.6).Conclusio n　There was no difference in nutritional evaluation between the EN and PN group,but the early enteral nutrition is superior in lowing the level of ser um glucos,the rate of stress ulcer and promoting nurological recovery to the par enteral nutrition.