摘要
目的探讨早期肠内营养支持与急性脑卒中致心脑综合征近期结局的关系。方法2010年1月-2014年1月神经内科收治急性脑卒中致心脑综合征患者100例,发病<72 h,均经颅脑CT或MR确诊。随机分为观察组和对照组各50例,观察组给予早期肠内营养支持,对照组给予肠外营养支持,对比分析2组患者临床疗效、营养支持前后营养指标、免疫指标及并发症情况。结果观察组患者总有效率92.0%高于对照组的72.0%(x^2=6.18,P=0.016)。观察组治疗第1天直至治疗结束,血红蛋白、总蛋白、白蛋白、前白蛋白等营养指标均逐渐降低,但治疗第10、21天各项营养指标变化与治疗第1天比较差异均无统计学意义(P>0.05);对照组患者治疗第1天直至治疗结束,各项营养指标均逐渐降低,治疗第10、21天各项营养指标变化与治疗第1天比较差异均有统计学意义(P<0.05);治疗21天后,血红蛋白、总蛋白、白蛋白等营养指标变化观察组与对照组比较差异均有统计学意义(P<0.05)。观察组治疗第1天直至治疗结束,总淋巴细胞计数(TLC)、IgA、IgG、IgM、C_3、C_4等免疫指标均逐渐降低,但治疗第10、21天各项免疫指标与治疗第1天比较差异均无统计学意义(P>0.05);对照组治疗第1天直至治疗结束,各项免疫指标均逐渐降低,治疗第10、21天TLC、IgA、IgG、C_3等免疫指标与治疗第1天比较差异均有统计学意义(P<0.05);观察组患者治疗21天后TLC、IgA、IgG、C_3等免疫指标与对照组比较差异均有统计学意义(P<0.05)。观察组患者治疗过程中发生感染2例,低蛋白血症5例,对照组患者中发生感染9例,褥疮6例,低蛋白血症8例,2组患者并发症发生率比较差异有统计学意义(x^2=4.23,P=0.039)。结论早期肠内营养能明显改善急性脑卒中致心脑综合征患者的营养状态,对提高机体免疫力、促进康复均有积极意义。
Objective To investigate the relationship between early enteral nutrition support and acute stroke in-duced cardio-cerebral syndrome in short term. Methods From 2010 January to 2014 January, 100 acute stroke patients in the department of neurology were enrolled, symptom occurred less than 72 h, disease was confirmed by cranio-cerebral CT or MR. They were randomly divided into observation group and control group with 50 cases in each group, the observation group re-ceived early enteral nutrition support, the control group were given parenteral nutrition support, comparative analysis between the 2 groups of patients were performed before and after clinical treatment, nutritional index, immune index and complications were compared. Results In the observation group, the total efficiency is 92. 0%, which is higher than that of the control group 72. 0% （χ^2 =6. 18, P =0. 016）. After the first day treatment, the observation group’s hernoglobulin, total protein, albumin, prealbumin as nutritional index were gradually reduced, but no significant differences of these nutritional indexes were found at 10th and 21st day of treatment from 1st day （ P 〉0. 05）;After the first day treatment, the control group’s nu-tritional indexes were gradually reduced, significant differences of these nutritional indexes were found at 10th and 21st day of treatment from 1st day （ P 〈0. 05）;21 days after treatment, hemoglobin, total protein, albumin and other nutritional indica-tors’ change in the observation group were significantly different from the control group （ P 〈0. 05）. After the first day treat-ment, the observation group’ s total lymphocyte count （ TLC） , IgA, IgG, IgM, C3 , C4 immune indexes were gradually re-duced,but no significant differences of these immune indexes were found at 10th and 21st day of treatment from 1st day（ P 〉0. 05）;After the first day treatment, control group’s immunological indexes were gradually reduced, significant differences of TLC, IgA, IgG, C3 were found at 10t
出处
《疑难病杂志》
CAS
2015年第2期125-128,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
肠内营养支持
早期
脑卒中
急性
心脑综合征
近期结局
相关性
Enteral nutrition support,early
Cerebral stroke,acute
Cardio-cerebral syndrome
Short-term outcome
Correlation
