Objective:To explore the clinical therapeutic efficacy and the best way of nutritional support and period in patients with severe head injury.Methods:128 patients with severe head injury were divided into internal nutrition group(ENG) and parenteral nutrition group(PNG)at random.Treated by emergent operations and 48 hours later

all the patients received the rationed nitrogen and calorie

containing nutritional support via different pathway.At the same time

we had been monitoring the nutrional indexes

the metabolic indexes

the complications of nutritional support and calculating the nutritional costs during the whole treatment.Results:The nutritional indexes were effectively maintained in both ENG and PNG

but the metabolic indexes

the complications of nutritional support and the nutritional cost of the PNG rose more obviously than those of ENG.Conclusion:Early postoperative EN and PN nutritional support could improve the nutritional status of the patient.EN had much benefit

including comprehensive nutrition

safety

convenience and low costs.It should be the first pathway for mutritional support.