摘要
目的:探讨序贯肠内营养(sequential enteral nutrition,SEN)支持对高血压脑室出血患者营养指标和预后的影响.方法:回顾性分析我院2011-09/2013-09收治的高血压脑室出血患者54例,根据治疗方法不同分为两组.试验组(n=29)入院第3天通过鼻胃管开始予以肠内营养(enteral nutrition,EN)制剂百普力,2-3 d后予以EN制剂能全力,共计14 d.对照组(n=25)予以等热卡量鼻饲流质及肠外营养支持.入院后2和16 d的进行美国国立卫生研究院卒中量表评分,进行血红蛋白(hemoglobin,Hb)、血清白蛋白(albumin ALB)、转铁蛋白(transferrin,TF)含量测定和含量,进行淋巴细胞计数(total lymphocyte count,TLC).统计腹泻、胃潴留、应激性胃肠道出血、肺感染发生率以及住院时间.结果:试验组入院第2天Hb、ALB、TF含量测定和TLC与对照组无统计学差异.试验组第16天Hb、ALB、TF含量测定和TLC均高于对照组(132.15 g/L±14.39 g/L vs 117.69 g/L±10.73g/L,39.65 g/L±7.88 g/L vs 32.15 g/L±5.48g/L,2.14 g/L±0.21 g/L vs 1.80 g/L±0.45 g/L2.13×109±0.39×109 vs 1.79×109±0.33×109,均P<0.05).试验组腹泻和胃潴留发生率和对照组无统计学差异.试验组应激性胃肠道出血、肺感染发生率显著低于对照组(3.45%vs 24.00%,6.90%vs 32.00%,均P<0.05),住院时间明显低于对照组(23.92 d±3.76 d vs 26.96d±5.53 d,P<0.05).结论:SEN能有效改善高血压脑室出血患者的营养状况,降低应激性胃肠道出血和肺感染的发生率,促进神经功能的恢复,减少住院时间.
AIM： To investigate the effect of sequential enteral nutrition on nutritional status and prognosis in patients with hypertensive intraventricular hemorrhage. METHODS： A retrospective analysis of 54 patients with hypertensive intraventricular hemorrhage treated at our hospital from September 2011 to September 2013 was performed. Depending on the mode of nutrition, the patients were divided into either an experimental group （n = 29） or a control group （n -- 25）. The experimental group received sequential enteral nutrition from the third day after admission, while the control group received isocaloric amount of liquid diet and parenteral nutrition. On the 2nd and 16th dafter admission, neurological scores were tested using the National Institutes of Health Stroke Scale （NIHSS）, and hemoglobin, albumin, trans- ferrin and lymphocyte count were recorded. The incidences of diarrhea, gastric retention, stress- induced gastrointestinal bleeding and pulmo- nary infection were observed. The hospitaliza- tion time of each patient was counted. RESULTS： On the 2nd d after admission, there were no significant differences in hemoglobin, albumin, transferrin or lymphocyte count between the experimental group and the control group. On the 16th d, hemoglobin, albumin, transferrin and lymphocyte count in the experi- mental group were significantly higher than those in the control group （132.15 g/L ±14.39 g/ L vs 117.69 g/L ± 10.73 g/L, 39.65 g/L ± 7.88 g/ L vs 32.15 g/L ± 5.48 g/L, 2.14 g/L ± 0.21 g/L vs 1.80 g/L ± 0.45 g/L, 2.13 × 10^9 ± 0.39 × 10^9 vs 1.79 × 10^9 ± 0.33 × 10^9, P 〈 0.05 for all）. The incidences of diarrhea and gastric retention showed no sig- nificant differences between the experimental group and the control group. The incidences of stress-induced gastrointestinal bleeding and pulmonary infection in the experimental group were significantly lower than those in the control group （3.45% vs 24.00%, 6.90% vs 32.00%, P 〈 0.05 for all）. The hospitalization time in the experimen
出处
《世界华人消化杂志》
CAS
北大核心
2014年第17期2493-2497,共5页
World Chinese Journal of Digestology
关键词
脑室出血
序贯肠内营养
应激性胃肠道出血
肺感染
Intraventricular hemorrhage
Sequential enteral nutrition
Stress-induced gastrointestinalbleeding
Pulmonary infection
