不同液体管理方案对ICU老年重症颅脑损伤术后患者组织氧合及肠功能的影响
Effect of different fluid management programs on the oxygenation and intestinal function of patients with severe craniocerebral injury after ICUZHU Yaoli1, KONG Fangen2, ZHU Chunli3,WANG Xiaohua1,YANG Jiawen1, Li Jing1

朱瑶丽,孔凡根,朱春丽,王小华,杨嘉雯、李晶.不同液体管理方案对ICU老年重症颅脑损伤术后患者组织氧合及肠功能的影响[J].内科急危重症杂志,2017,23(3):

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英文关键词:old age severe craniocerebral injury postoperative tissue oxygenation intestinal function

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作者	单位	E-mail
朱瑶丽	中山大学附属第五医院重症监护科	shijinming2012@126.com
孔凡根	中山大学附属第五医院神经外科
朱春丽	广东省第二人民医院移植科
王小华	中山大学附属第五医院重症监护科
杨嘉雯、李晶	中山大学附属第五医院重症监护科

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中文摘要:

【】目的探讨不同液体管理方案对ICU老年重症颅脑损伤术后患者的组织氧合功能及肠功能的改善效果。方法选取2012年1月至2015年12月期间本院收治的72例重度颅脑损伤术后患者作为研究对象,随机分为对照组和实验组各36例,对照组采用肠内营养和肠外营养支持的序贯疗法,研究组患者采用早期肠内营养支持疗法。对比治疗后两组患者的循环功能、组织氧合功能及肠功能指标。结果观察组的HR、CVP 、MAP、PAWP、MPAP、CO、PVR、SVR及Lac较对照组均可见显著改善(P<0.05)；观察组患者的各项氧代谢指标均较对照组有明显改善(P<0.05)；观察组患者的平均肠鸣音恢复时间及肛门排气/排便时间均短于对照组,腹痛、腹泻、腹胀现象的发生率均低于对照组,差异具有统计学意义(P<0.05)。结论早期肠内营养支持疗法可明显改善ICU老年重症颅脑损伤术后患者的循环功能及氧代谢障碍,恢复肠功能,降低术后并发症的发生。

英文摘要:

s：Objective to investigate the effect of different liquid management on the oxygenation and function of the patients after severe craniocerebral injury in ICU aged patients.. Methods the 2012 January 2015 to December in our hospital during the period of 72 cases of severe craniocerebral injury after operation patients as the research object, randomly assigned for control group and the experimental group (36 cases) and control group was treated with sequential therapy of enteral nutrition and parenteral nutrition support, the study group of patients with early enteral nutrition support therapy. The circulatory function, tissue oxygenation function and intestinal function index of the two groups were compared after treatment. Results the observation group HR, CVP, map, PAWP, mPAP, Co, PVR and SVR and LAC than in the control group showed improved significantly (P < 0.05); observation group were the oxygen metabolism index were lower than those in the control group improved significantly (P < 0.05); observation group of patients with average recovery of bowel sound time and the anus exhaust / defecation time were shorter than the control group, abdominal pain, diarrhea, bloating the incidence was significantly lower than that of control group, the difference is statistical significance (P < 0.05). Conclusions early enteral nutrition support therapy can improve the circulatory function and oxygen metabolism disorder of ICU aged patients with severe craniocerebral injury, recover the intestinal function and reduce the occurrence of postoperative complications..