Nasal jejunal tube and nasogastric tube of two different catheter ways in improving the severe craniocerebral injury and the low temperature condition compared the curative effect of early enteral nutrition support / 中国医师进修杂志

ABSTRACT

Objective To investigate the application of nasal jejunal tube and nasogastric tube of two different catheter ways in improving the severe craniocerebral injury and the low temperature condition and the role of early enteral nutrition support and compare the difference between its curative effect.Methods A total of 120 patients with severe craniocerebral injury underwent normal and low temperature treatment were selected,and they were divided into nasal jejunal tube enteral nutrition(nasal jejunal tube group,60 cases)and nasogastric tube enteral nutrition(nasogastric tube group,60 cases)by simple random sampling.After implement nasogastric tube and nasal jejunal tube,normal pressure using enteral nutrition elemental diet and/or enteral nutrition multi polymerization agent produced the best nutrient solution implementation of early enteral nutrition support,two groups of subjects under the condition of bowel function exists,within 48 h starting enteral nutrition,compared two groups of various nutrition indicators as well as adverse reactions and complications,and Glasgow Coma Scale(GCS)score,Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ)score,etc.Results The patients with severe craniocerebral injury after early nutrition,the various nutrition indicators had improved in two groups.The rise extent of triceps skinfold thickness,arm muscle circumference,serum albumin,prealbumin,transferrin,hemoglobin and other indicators in nasal jejunal tube group was higher than that in nasogastric tube group on the 14th,28th day after admission,and there was significant difference(P ＜ 0.05).The incidence of diarrhea,bloating,vomiting,and stomach contents reflux retention in nasal jejunal tube group was lower than that in nasogastric tube group [5.0％(3/60)vs.18.3％(11/60),10.0％(6/60)vs.21.7％(13/60),5.0％(3/60)vs.21.7％(13/60),15.0％(9/60)vs.16.7％(10/60),11.7％(7/60)vs.48.3％(29/60),8.3％(5/60)vs.21.7％(13/60)],and there was significant difference(P ＜ 0.05).The incidence of complications in nasal jejunal tube group was lower than that in nasogastric tube group [16.7％(10/60)vs.76.7％(46/60)],and there was significant difference(P ＜0.05).The changes of GCS score,APACHE score in nasal jejunal tube group was more obvious than that in nasogastric tube group,and there was significant difference(P ＜ 0.05).Conclusions Early nasal jejunal tube enteral nutrition for the severe craniocerebral injury after the low temperature condition in clinical enteral nutrition implementation is feasible and reasonable,compared with a nasogastric tube feeding,can obviously reduce the complications of enteral nutrition and reach goals earlier nutritional therapy,can improve the prognosis.