The Clinical Search Of Early Enteral Nutrition In Neurosurgical Critical Patients

Objective To discuss the clinical characteristic and curative effect of early enteral nut-rition (EN) on the severe neurosurgical patients in early stage(48h). Methods Sixty-three cases of severe neurosurgical patients (GCS≤8) were randomly divided into treatment group(32 cases) and control group (31cases). The nasogastric (jejunal) tube was inserted for the patients of treatment group after 24 hours in hospital and enteral nutrition was given 48 hours later. The initial amount (20ml～50ml/h) of the EN were given in the first day and increased gradually. The Calorie deficiency part was complemented by intravenous sup-plement. The total amount(2000ml) of enteral nutrition was achieved in the 7th day by the application of 20°～30°head-raising, uniform instillation of nasogastric feeding controlled by the nutrition feeding pump. And the speed-control nutrition feeding pump. And the pa-tients in the control group received the conventional delayed enteral nutrition support. The nasal feeding of liquid food was provided when the peristaltic sound appeared 6～7d after injury. The variations of serum protein, blood glucose, hemoglobin, serum～albumin, lym-phocyte were recorded in the 7th and the 14th day after treatment. In addition, the variations of arm muscle circumference(AMC), triceps skinfold thickness(TSF) also need to be record-ed in the 14th treatment day. The incidence of complications and prognosis were observed and compared in the two groups. Results The blood sugar of the patients in the treatment group was significantly lower than the control group(P<0.05). The total lymphocyte count, se-rum protein, albumin, nitrogen balance values were all superior to the control group(P<0. 05). Arm musele circumference (AMC)and triceps skinfold thickness (TSF) of the treat- ment group were significantly better than the control group(P<0.05). In the treatment group, the nutritional parameters were superior to the control group, the complications were less than that in the control groups(P<0.05), and the prognosis were markedly improved compared with the controls (P< 0.05). Conclusions Early enteral nutrition in the severe neurosurgical patients can decrease the complications and improve prognosis of the patients.