摘要： 观察颅脑创伤后早期肠内营养治疗与中心静脉置管肠外营养对重型颅脑创伤患者近期预后的影响。结果显示，早期肠内营养组患者治疗第7 和14 天时，血清总蛋白［（62.04 ± 2.09）和（66.04 ±2.27）g/L］、白蛋白［（37.75 ± 2.86）和（43.43 ± 2.37）g/L］以及前白蛋白［（177.87 ± 13.89）和（199.43 ±11.01）mg/L］水平高于肠外营养组（均P = 0.000）；治疗第7 天时胃出血发生率（14.29%，4/28）低于肠外营养组（39.29%，11/28），且差异具有统计学意义（χ² = 4.462，P = 0.035）；第14 天时，肠内营养组无一例发生胃出血，与肠外营养组（14.29%，4/28）差异无统计学意义（χ² = 2.423，P = 0.120）。两组患者治疗期间肺感染发生率，组间差异无统计学意义（χ² = 0.287，P = 0.592）。提示重型颅脑创伤患者应早期接受肠内营养支持治疗，提供足够的营养支持，减少胃出血发生率。

关键词: 脑损伤, 肠道营养, 蛋白质类

Abstract: This paper aims to compare the effect on early prognosis of post-traumatic early enteral nutrition therapy and central venous catheterization parenteral nutrition therapy in patients with severe traumatic brain injury (sTBI). The results showed that on 7 and 14 d, serum total protein [(62.04 ± 2.09) and 66.04 ± 2.27) g/L], albumin [(37.75 ± 2.86) and (43.43 ± 2.37) g/L] and prealbumin [(177.87 ± 13.89) and (199.43 ± 11.01) mg/L] in patients treated with early enteral nutrition were all higher than patients treated with parenteral nutrition (P = 0.000, for all). On 7 d the stomach bleeding rate of patients treated with enteral nutrition (14.29%, 4/28) was lower than patients treated with parenteral nutrition (39.29%, 11/28), and the difference was statistically significant (χ² = 4.462, P = 0.035). On 14 d, no one case of stomach bleeding occured in patients with enteral therapy, while 4 cases of stomach bleeding (14.29%) occured in patients with parenteral therapy, and the difference was not significant ( χ² = 2.423, P = 0.120). The difference of lung infection rate between different treated patients was not statistically significant ( χ² = 0.287, P = 0.592). Early enteral nutrition therapy for severe traumatic brain injury patients can provide adequate nutritional support and reduce the incidence of stomach bleeding.

Key words: Brain injuries, Enteral nutrition, Proteins