The efficacy of two different nutritional methods in treatment of severe head injury

Li Qian-feng; Huang Qiao-chun; Huang Cong -gang; Chen Xiao -bin; Wu Jing -lei; Duan Fa -liang

doi:10.3969/j.issn.1002-1949.2019.01.006

Abstract：Objective To explore the clinical value and curative effect of early percutaneous endoscopic gastrojejunostomy( PEG - J) in the treatment of severe head injury ( SHI). Methods PEG-J in the treatment of 40 SHI cases ( PEG-J tube group) and nasal gastric tube treatment of 30 SHI cases (nasal gastric tube group) clinical data were retrospectively analyzed in our department. The paralysis side of triceps skin fold ( TSF), body mass index ( BMI), serum albumin ( propagated), hemoglobin (Hb) of the first and 21st d of enteral nutrition were compared in 2 groups;gastrointestinal dysfunction ( gastrointestinal contents retention, vomiting, regurgitation, diarrhoea, constipation) and complications (mainly observe aspiration pneumonia, gastrointestinal bleeding), length of hospital stay, and Glasgow outcome score(GOS) were observed. Results The human body index and blood index of the PEG-J group [TSF:(11. 58 ± 1. 38) mm, BMI(20. 51 ± 1. 50) kg/m2, Alb(40. 98 ± 4. 41) g/L, Hb(113. 68 ± 21. 68) g/L] were better than that of the nasal gastric tube group[TSF(10. 78 ± 1. 72) mm, BMI(19. 13 ± 1. 60)kg/m2, Alb(35. 00 ± 2. 36) g/L, Hb(96. 37 ± 16. 24) g/L,P<0. 05). The gastrointestinal dysfunction of the PEG-J group was significantly lower than that of the nasal gastric tube group (P<0. 05). The complications of PEG -J group were less than that of the nasal gastric tube group, and the length of hospitalization [(23. 28 ± 1. 66) d]was less than that of the nasal gastric tube group[(27. 67 ± 2. 09) d] (P<0. 05). The GOS of PEG-J group was better than that of the nasal gastric tube group (P <0. 05). Conclusion PEG -J surgery is a safe, effective, less complicated operation that provides the best method for the nutritional support of the patients with SHI.