Efficacy of early enteral nutrition support for patients with coma after neurosurgery

Zhong Xiaochun ； Huang Shaomin ； Lin Lian ； Zhang Xuemei

《Medical Research》 2卷2期 (2020/06) Pp. 26-31

https://doi.org/10.6913/MRHK.202006_2(2).0004

摘要

Objective: This study aimed to explore the efficacy of early enteral nutrition support for patients with coma after neurosurgery. Methods: A total of 50 hospitalized patients with severe craniocerebral injuries who was in a coma after neurosurgery from September 2018 to January 2020 were enrolled in the study. The patients were randomly divided into two groups (25 cases/group) using the random number table method. The control group received delayed enteral nutrition support, while the experimental group received early enteral nutrition support. Their nutritional status indicators, serum inflammatory factors, immunity indicators, complication incidence, Glasgow Coma Scale (GCS) score, recovery time, mechanical ventilation duration, and inpatient days were compared between the two groups. Results: Although the levels of nutritional status indicators (including prealbumin, transferrin, albumin, and hemoglobin) increased in both groups after treatment, their levels were significantly higher in the early enteral nutrition support group than in the control group (P＜0.05), concomitant with lower levels of serum interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT), and higher levels of CD^3+% and CD4/CD8 ratio in the peripheral circulation (P＜0.05). Regarding the complication incidence, no complication was observed in the early enteral nutrition support group, while 4 (16%) cases in the control group had ventilator-associated pneumonia (n=1), diarrhea (n=2), or refeeding syndrome (n=1), P＜0.05. The GCS scores of the two groups were higher after treatment than before treatment (P＜0.05). However, the GCS score after treatment was higher in the early enteral nutrition support group than the control group (P＜0.05). The recovery time, mechanical ventilation duration, and inpatient days were shorter in the early enteral nutrition support group than in the control group (P＜0.05). Conclusions: Early enteral nutrition for post-operative coma patients with severe craniocerebral injury could effectively improve nutritional status of patients, reduce inflammation, enhance immunity, reduce complication incidence, and promote patients' recovery.

關鍵字

Neurosurgery ； Severe craniocerebral injury ； Coma ； Early enteral nutrition support