Efficacy Evaluation Of PEG In The Nutritional Support Of Patients With Severe Craniocerebral Injury

Research objectiveAnalyzed the benefit and shortage of percutaneous endoscopic gastrotomy(PEG) for enternal nutrition in severe craniocerebral injury patients admitted in the department o f Neurosurgery.Exploration the application value of PEG in the nutritional support of patients with severe craniocerebral injury.Data and methodsWe selected 40 patients with severe craniocerebral injury admitted in China-Japan Union Hospital of Jilin University from July 2007 to July 2008.The inclusion criteria are as follow:the GCS scores of patients were between 3-8,with conscious disturbance of different degrees.All the patients need nutritional support more than 1 month;There were no structural disease of other important organs;There were no diabetes and other endocrine diseases;There were no severe injury of other important organs;All the patients have no contraindication of percutaneous endoscopic gastrotomy.The patients were divided into control group and experimental group.In the control group,there were 10 men and 10 women,The ratio of male to female was 1:1.The median age was 42.4 years.GCS scores:6-8,6 cases,3-5,14 cases.In the experiment group, there were 11 men and 9 women,The ratio of male to female was 1.2:1. The median age was 44 years.GCS scores:6-8,5 cases,3-5,15 cases. There was no significant difference between the two groups in sex,age and GCS score.The patients' Serum Albumin,Hemoglobin,the lymphocyte percentage,weight,the perimeter of middle part arm and GCS score were detected at 1day,7days and 21days after nutritional support.And the rate of gastrointestinal complication such as abdominal distension,diarrhea and constipation et al,and aspirated pneumonia of the two groups were analyzed.ResultsThe patients' Serum Albumin,Hemoglobin,the lymphocyte percentage,weight,the perimeter of middle part arm and GCS score of observation group was higher than that of control group,and the difference was significant(P＜0.05).Gastrointestinal complication such as abdominal distension,diarrhea and constipation et al,and aspirated pneumonia of observation group was lower than that of control group, and the difference was significant(P＜0.05).ConclusionNutritional support by percutaneous endoscopic gastrostomy can improve the nutritional status of patients with severe craniocerebral injury;Nutritional support by percutaneous endoscopic gastrostomy reduce the gastrointestinal complication such as abdominal distension, diarrhea and constipation et al in patients of severe craniocerebral injury;Nutritional support by percutaneous endoscopic gastrostomy reduce the rate of aspirated pneumonia in patients of severe craniocerebral injury;Nutritional support by percutaneous endoscopic gastrostomy is superior to routine nasogastric feeding in the consciousness recovery in patients of severe craniocerebral injury.PEG is a safe,effective method for enteral nutrition with low risk of complications.