摘要目的 探讨高压氧治疗中重型颅脑损伤患者实施早期肠内营养及高压氧治疗期间调整管饲液配方预防上消化道出血、肠胀气的效果.方法 中重型颅脑损伤伴昏迷患者分成观察组和对照组,各31例,观察组应用适宜营养制剂行早期肠内营养,在高压氧治疗期间应用自制管饲液行肠内喂养;对照组早期行静脉营养,高压氧治疗期间选用市售能全力制剂.观察上消化道出血、肠胀气发生率.结果 高压氧治疗前观察组发生上消化道出血2例(6.5%),对照组8例(25.8%);高压氧治疗时观察组发生肠胀气3例(9.7%),对照组10例(33.0%).2组比较,上消化道出血与肠胀气发生率差异均有统计学意义(P＜0.05).结论 适宜营养制剂进行早期肠内营养,可以减少颅脑损伤患者上消化道出血,利于患者进行早期高压氧治疗;在高压氧治疗期间自制管饲液可以减少高压氧治疗时的肠胀气发生率,减轻胃肠不适,利于康复.

abstractsObjective To investigate effects of early enteral nutrition and nutrition component adjustment in preventing and reducing the upper gastrointestinal bleeding and flatulence during hyperbaric oxygen(HBO)therapy on patients with severe craniocerebrai injury.MethodsSixty-two esses of severe craniocerebrai injury with coma were randomly divided into observed group(n=31)and control group(n=31).The patients in the observed group were given early enteral nutrition with appropriate nutrition preparations and self-made nutrition preparations during HBO therapy.Patients in the control group were given total parenteral nutrition in early and enteral nutritional suspension during HBO therapy.Incidence rates of breeding and intestinal tympanites in upper gastrointestinal were observed.Results Before HBO therapy,two patients experienced upper gastrointestinal bleeding with the incidence of 6.5% in observed group and 8 cases(25.8%)in control group(P＜0.05).During HBO therapy,three patients occured intestinal tympanites with the incidence of 9.7% in observed group and 10 cases with the incidence of 33.0% in control group(P＜0.05).Conclusions Early enteral nutrition with appropriate nutrition preparations can inhibit upper gastrointestinal bleeding.At the salne time,self-made nutrition preparations can reduce flatulence incidence during HBO therapy and relief gastrointestinal discomfort.