| Objective:There may exist dangerous of dystrophy in acute craniocerebral injury patiens for its high energy consumption. During the treatment process of acute craniocerebral injury patiens, effective nutritional support could improve metabolism, correct negative nitrogen balance, and promote the recovery of function of cranial nerves and improve prognosis. This topic aimed to retrospective study the good quality and shortcoming of parenteral nutrition+enternal nutrition ordering treatment and simple enternal nutrition and directly nursing interventions were taken to acute craniocerebral injury patiens. And to supply better nutritional support therapy for patients.Methods:120patients with acute craniocerebral injury in departments of emergency (including patients transferred into patients’room), ICU, neurosurgery ICU and patients’room of Xiangya hospital. The therapies of nutritional support were according to the need of patients’condition, one part of patients were PN+EN, and another parts were EN:80patients were given early parenteral nutrition (PN) and delayed enternal nutrition (EN) as treatment group (PN+EN),40patienes were given were given total enteral nutrition (EN) as contral group. PN+EN were supplied with PN after injured or operation24h. PN were given with20%middle and long chain fat milk,18type of amino acid, glucose,10%kalium chloratum,10%sodium chloride, water-solubility and fat-soluble vitamin, microelement and macroelement. And EN were used Nutrison Fibr (Holland, NUTRICIA co. LTD)2000-4000ml/d after injured3day. Simple EN group used Nutrison Fibr2000-4000ml/d after injured24h.10day or21day later, the mean weight (MW), Body Mass Index (BMI), plasma-albumin (PA), hemoglobin (HB) and total lymphocyte count (TLC) were detected and were anylasized by SPSS17.0. And the clinical curative effect and ratio of infection were observed. And take directly nursing interventions to deal with those various kinds of complications appeared during nutritional support. It is the need of clinic therapy that those nursing intervention were directly taken to acute craniocerebral injury patients. Those nursing intervention including:general duty nursing, emergency nursing, body position nursing, body position nursing, respiratory tract nursing, transfuse nursing, mental nursing, and complication nursing, and so on.Results:Before treatment, there were not significantly difference between PN+EN and EN in ages, gender, GCS, MW, BMI, PA, HB and TLC (P>0.05). After treated for10and21day, the level of MW and BMI were all decreaed in PN+EN but without significantly difference compare to that of before treatment (P>0.05). the level of MW and BMI were decreaed significantly in EN compare to that of before treatment, and there were significantly difference between EN and PN+EN (P<0.05), but there were no significantly difference between10d and21d in the two groups. The level of PA、HB and PA in PN+EN group are all significantly higher than EN group (P<0.05); but there were no significantly difference between10d and21d in the two groups. The curative effect were90.0%and67.5%in PN+EN and EN, respectively. And there are higher curative effect in PN+EN group than EN group (P<0.05). The total infection ratio were8.75%and22.5%in PN+EN and EN, respectively. And there are lower infective ratio in PN+EN group than EN group (P<0.05).Conclusion:1. PN+EN treatment could maintain the body weight and improve the level of PA, HB AND TLC and help recovering patient’s condition in acute craniocerebral injury patiens. 2. PN+EN treatment had higher curative effect and lower infective ratio. And may be a better ideal nutritional support treatment in acute craniocerebral injury patrens.3. Effectively nursing intervention were important to the therapy and recovery, and decreasing of complication in acute craniocerebral injury patiens. |
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