Clinical analysis on the treatment of 24 cases of severe traumatic brain injury with non ventral intestinal obstruction

Abstract

Objective To discuss the clinical treatment for severe traumatic brain injury (sTBI) with non ventral intestinal obstruction. Methods A total of 48 patients with sTBI were enrolled in this study, including 24 with (observation group) and 24 without (control group) non ventral intestinal obstruction. Among 24 patients with non ventral intestinal obstruction, 3 cases (12.50%) were treated by craniotomy evacuation of hematoma, 5 cases (20.83%) were treated by craniotomy evacuation of hematoma and decompressive craniectomy, and 16 cases (66.67%) were treated by conservative treatment. They were all treated by gastrointestinal decompression and parenteral nutrition. Among 24 patients without non ventral intestinal obstruction, 4 cases (16.67%) were treated by craniotomy evacuation of hematoma, 6 cases (25%) were treated by craniotomy evacuation of hematoma and decompressive craniectomy, and 14 cases (58.33%) were treated by conservative treatment. They were all treated by enteral nutrition. Hemoglobin (Hb), albumin (ALB) and prealbumin (PA) were detected 10 and 20 d after treatment. Results Compared with control group, the level of Hb (P = 0.008), ALB (P = 0.002) and PA (P = 0.031) were significantly reduced in observation group. Compared with 10 d after treatment, the level of Hb (P = 0.003), ALB (P = 0.000) and PA (P = 0.005) were significantly reduced 20 d after treatment. Conclusions Early diagnosis and timely treatment for non ventral intestinal obstruction in patients with severe traumatic brain injury could effectively relieve the symptoms of intestinal obstruction, and is favorable to early enteral nutrition, so as to enhance the patients' recovery.

DOI: 10.3969/j.issn.1672-6731.2017.01.012