摘要
目的:探讨不同肠内营养治疗方式对急性脑梗死(72h内)患者的营养状况及预后的影响。方法:将80例急性脑梗死伴吞咽障碍患者随机分为序贯肠内营养组、整蛋白肠内营养组(各40例)。序贯组患者给予短肽型肠内营养制剂(总量按84～126kJ·kg-1·d-1)鼻饲3d,第4天起改用整蛋白型肠内营养制剂鼻饲;整蛋白组给予整蛋白型肠内营养制剂鼻饲;均持续≥10d以上。观察2组患者营养治疗后第1,7,14天的营养指标[三头肌皮褶厚度(TSF),上臂三头肌肌围(MAMC),血清白蛋白(ALB),血清前白蛋白(PAB)、血红蛋白(Hb)含量]、感染并发症及神经功能评分(NIHSS)、Barthel指数(BI)和胃肠道不良反应。结果:序贯组在治疗后第14天营养指标(血清前白蛋白、白蛋白含量)明显高于整蛋白组(均P<0.05);感染并发症发生率明显低于整蛋白组(P<0.05);胃肠道不良反应发生率明显低于整蛋白组(P<0.01);治疗后第14天NIHSS评分明显低于、BI值明显高于整蛋白组(均P<0.05)。结论:序贯肠内营养治疗能够改善急性脑梗死患者的营养状况,降低感染并发症及胃肠道不良反应的发生率,改善患者的近期预后。
OBJECTIVE To explore the influence of the two enteral nutrition method on nutritional status and outcome in acute cerebral infarct patients（72 h）. METHODS Totally, 80 acute cerebral infarct patients complicated with dysphagia were divided into two groups including sequential enteral nutrition group（SEN） and integral-protein enteral nutrition group（40 patients in each group）. In the first three days patients in SEN group were nasally fed with short-peptide enteral nutrition（84- 126 kJ · kg^-1·d^-1） which would be replaced with integral-protein enteral nutrition from the forth day. Patients in control group were provided with integral-protein enteral nutrition by nasal feeding. Nutrition support for both groups lasted more than 10 days. In the first, seventh and fourteenth day, data of both groups concerned with mean upper arm muscle circumference of triceps, serum albumen, serum prealbum, heamoglobin, incidence of infectious complications, neuro function score（NHISS）, Barthel Index and incidence of the gastrointestinal adverse reaction were collected and analyzed. RESULTS Nutritional indexes （serum prealbum, heamoglobin） in the group of the sequential enteral nutrition were significantly higher than those in integral-protein enteral nutritian group （P〈0. 05） in the fourteenth day . we also found a significant decrease of infectious complications and incidence of the gastrointestinal adverse reaction in studied group compared to that in control group（P〈0.05 - P〈0. 01 ）. Similar changes also could be seen in NHISS scores of two groups. But Barthel Index in studied group was statisitically higher than that in control group（P〈0. 05）. CONCLUSION The sequential enteral nutrition can improve the nutritional status in acute cerebral infarct patients and may be helpful for the impaired neuro-function recovery and improve the short-term prognosis.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2010年第11期936-938,共3页
Chinese Journal of Hospital Pharmacy
基金
温州市科技局基金资助项目(Y20090421)
关键词
急性脑梗死
序贯肠内营养
营养状况
预后
acute cerebral infarct
sequential enteral nutrition
nutritional status
outcome
