赖红宇,王留根,李和平,等.间歇经口至食管管饲法对重型颅脑损伤患者功能恢复的影响[J].中华物理医学与康复杂志,2021,43(12):1117-1120
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| 间歇经口至食管管饲法对重型颅脑损伤患者功能恢复的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.12.014 |
| 中文关键词: 间歇经口至食管管饲法 重型颅脑损伤 营养不良 气管切开 |
| 英文关键词: Intermittent tube feeding Brain injury Malnutrition Tracheotomy |
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| 中文摘要: |
| 目的 观察间歇经口至食管管饲法(IOE)对重型颅脑损伤伴气切患者功能恢复的影响。 方法 采用随机数字表法将98例重型颅脑损伤伴气切患者分为观察组及对照组。2组患者均常规给予营养神经、抗感染、物理因子治疗、针灸及运动干预等，观察组患者入科评估后采用IOE管进行间歇置管营养支持，对照组患者入科后采用鼻胃管管饲法(NGT)进行营养支持。于入组时、治疗4周后对2组患者营养状况、并发症发生率、气切套管拔管时间和拔管率、格拉斯哥昏迷量表（GCS）评分进行比较。 结果 治疗4周后观察组患者血红蛋白、白蛋白、前白蛋白含量［分别为（119.69±12.85）g/L、（40.30±3.43）g/L和（234.88±46.31）mg/L］及体重指数［（20.71±2.38）kg/m2］均显著优于对照组水平(P<0.05)；同时观察组并发症总体发生率、气切套管拔管率（87%）、气切套管保留时间［（16.93±3.64）d］及GCS评分［（8.65±1.95）分］亦显著优于对照组水平(P<0.05)。 结论 IOE较NGT能更有效改善重型颅脑损伤伴气切患者营养状况及意识水平，有助于尽早拔除气切套管及抑制并发症发生。 |
| 英文摘要: |
| Objective To explore the effect of intermittent oro-esphageal tube feeding (IOE) on functional recovery from severe brain injury complicated by tracheotomy. Methods A total of 98 patients with severe brain injury and tracheotomy were randomly divided into an observation group and a control group. All received neurotrophic and anti-infection medication, physical therapy, acupuncture and exercise. The observation group was also given intermittent oro-esophageal tube feeding, while the control group was given nasogastric tube feeding for 4 weeks. Before and after the treatment, each patient′s nutritional status, extubation time and extubation rate of the tracheotomy, and Glasgow Coma Scale score was evaluated as well as the incidence of complications. Results After the 4 weeks the average hemoglobin, albumin and pre-albumin levels of the observation group and its average body mass index were all significantly better than the control group′s averages. It also had a significantly better overall incidence of complications, average extubation rate, average extubation duration and average GCS score. Conclusions Where feasible, intermittent oro-esphageal tube feeding is superior to nasogastric tube feeding for improving the nutritional status and consciousness level of patients with severe brain injury. It promotes early removal of the tracheotomy cannula, which inhibits complications. |
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