Abstract: Brain-dead patients are a significant source for organ transplantation, but complications such as intestinal ischemia and necrosis often affect organ quality. This study retrospectively analyzed the clinical data of three patients who became brain-dead following brain injuries due to different etiologies. All three patients rapidly developed severe enteral nutrition intolerance after early initiation of enteral nutrition, and subsequent organ procurement surgeries confirmed varying degrees of intestinal ischemic necrosis. The occurrence of severe intolerance following early enteral nutrition in brain-dead patients may signal the presence of intestinal ischemia and necrosis. Clinicians should be vigilant regarding such signs, promptly assess intestinal perfusion and structural damage, and further research is needed in the future to optimize nutritional support strategies for brain-dead patients and improve the quality of organs obtained.

Key words: intestinal ischemia-reperfusion injury, early enteral nutrition, management of brain-dead patients

摘要： 脑死亡患者是器官移植的重要来源,但肠道缺血坏死等并发症往往影响器官质量。本研究回顾性分析3例因不同病因致脑损伤后脑死亡患者的临床资料,3例患者均在早期启动肠内营养后迅速出现严重肠内营养不耐受表现,后续在器官获取术中均证实存在不同程度的肠道缺血坏死改变。脑死亡患者早期肠内营养后出现严重不耐受,可能是已出现肠道缺血坏死的信号,临床中对此类征象应提高警惕,及时评估肠道灌注与结构损伤,未来需要进一步研究,以优化脑死亡患者营养支持策略并提高器官获取质量。

关键词: 肠道缺血再灌注损伤, 早期肠内营养, 脑死亡患者管理