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

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

[1]  Xinying Wang,et al.  Nutrition Status, Nutrition Support Therapy, and Food Intake are Related to Prolonged Hospital Stays in China: Results from the NutritionDay 2015 Survey , 2016, Annals of Nutrition and Metabolism.

[2]  S. Parthasarathy,et al.  Anesthetic management of intestinal obstruction: A postgraduate educational review , 2016, Anesthesia, essays and researches.

[3]  S. Castaldi,et al.  Adhesions small bowel obstruction in emergency setting: conservative or operative treatment? , 2016, Il Giornale di chirurgia.

[4]  F. Paye,et al.  [Diagnosis and treatment of an intestinal obstruction]. , 2016, Revue de l'infirmiere.

[5]  L. Chin,et al.  Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors. , 2016, Cell transplantation.

[6]  X. Jiang,et al.  Adhesive small-bowel obstruction treatment using internal intestinal splinting with a nasointestinal ileus tube. , 2015, Minerva chirurgica.

[7]  S. Van Biervliet,et al.  Nutrition and pancreatic enzyme intake in patients with cystic fibrosis with distal intestinal obstruction syndrome. , 2015, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[8]  H. Yan,et al.  Research progress of early rehabilitation therapy on severe traumatic brain injury , 2014 .

[9]  Fengge Zhang,et al.  Clinical observation of early enteral nutrition therapy for patients with severe traumatic brain injury , 2014 .

[10]  K. Okamoto,et al.  [Ileus and intestinal obstruction]. , 2013, Nihon rinsho. Japanese journal of clinical medicine.

[11]  F. Ji,et al.  A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction. , 2012, World journal of gastroenterology.

[12]  A. Mahapatra,et al.  The prognostic significance of the timing of total enteral feeding in traumatic brain injury , 2012, Surgical neurology international.

[13]  A. Ogedegbe,et al.  Letter 1: Clinicoradiological score for predicting the risk of strangulated small bowel obstruction (Br J Surg 2010; 97; 1119–1125) , 2010, The British journal of surgery.

[14]  K. Kubota,et al.  Transnasal Fine Gastrointestinal Fiberscope-guided Long Tube Insertion for Patients with Small Bowel Obstruction , 2009, Journal of Gastrointestinal Surgery.

[15]  S. Kubo,et al.  Predictive factors for surgical indication in adhesive small bowel obstruction. , 2008, American journal of surgery.

[16]  J. Borg,et al.  Nutritional treatment of patients with severe traumatic brain injury during the first six months after injury. , 2007, Nutrition.

[17]  Bao Hong-pin.  Effect of enteral nutrition support therapy on the prognosis of post-operative patients with severe traumatic brain injury , 2007 .

[18]  T. Oh,et al.  Gastric emptying following brain injury: Effects of choice of sedation and intracranial pressure , 1995, Intensive Care Medicine.

[19]  R. Dempsey,et al.  Altered gastric emptying in the head-injured patient: relationship to feeding intolerance. , 1991, Journal of neurosurgery.

[20]  M. Gutman,et al.  [Pathophysiology of intestinal obstruction: innovations]. , 1990, Harefuah.