摘要
目的通过对急性脑卒中伴吞咽障碍患者进行回顾性分析,了解营养干预对临床预后的影响。方法研究阶段为2015年1月1日-2016年12月31日,共纳入研究对象99例,均为急性脑卒中患者,根据营养干预时间不同进行分组,分为入院24小时组、48小时组、7天后组,每组各33例,采取相同的营养干预措施,对比3组吞咽功能、神经功能、营养指标、凝血指标、临床结局。结果入院24小时组吞咽功能改善总有效32例(96.97%)、NIHSS评分(14.87±1.56)与48小时组吞咽功能改善总有效29例(87.88%)、NIHSS评分(19.01±1.66)差异显著,P<0.05。入院24小时组、48小时组吞咽功能、NIHSS评分分别与7天后组比较,差异显著,P<0.05。入院24小时组、48小时组Alb、PA、Hb、BTC与7天后组比较,差异显著,P<0.05。入院24小时组APTT(25.78±5.44)t/s、PT(11.43±2.32)t/s、AT-Ⅲ(0.23±0.066)VU与48小时组APTT(33.05±4.97)t/s、PT(14.21±2.45)t/s、AT-Ⅲ(0.35±0.07)VU差异不显著,P>0.05。入院24小时组、48小时组APTT、PT、AT-Ⅲ与7天后组比较,差异显著,P<0.05。入院24小时组并发症发生率1例(3.03%)、卧床时间(4.89±0.13)天与48小时组并发症发生率5例(15.15%)、卧床时间(7.05±0.22)天差异显著,P<0.05。入院24小时组、48小时组并发症发生率、卧床时间与7天后组比较,差异显著,P<0.05。结论针对急性脑卒中患者在入院后24开展营养干预可有效改善脑卒中患者预后,比国际指南中提到的入院后24小时~48小时优势明显,可改善患者营养不良情况。
Objective The acute stroke patients with swallowing disorder with were retrospectively analyzed to understand the impact of nutrition intervention on clinical outcomes. Methods the research phase for January1 st,2015 to December 31 st,2016,99 cases with into the object of study,are for patients with acute cerebral apoplexy,according to different grouped nutritional intervention time,divided into 24 h,48 h group admission to hospital,after 7 d group,33 cases in each group,to take the same nutritional interventions,compared three groups of swallowing function,nerve function,nutrition index,coagulation index and clinical outcome. Results The swallowing function improved hospital 24 h group total effective 32 cases（96.97%）,NIHSS score（14.87-1.56）and 48 h group of swallowing function to improve the total effective 29 cases（87.88%）,NIHSS score（19.01＋1.66）significant difference,P〈0.05）. The swallowing function and NIHSS score of the 24 h group and 48 h group were compared with the group after 7 d,and the difference was significant,P〈0.05. Propagated admitted to hospital 24 h group（48.04＋2.11）for g/L,PA（366.94＋/-22.09 mg/L,Hb（156.65＋14.72）g/L,BTC（4.12＋0.24）tendency and 48 h/L group propagated（37.69＋2.08）g/L,PA（269.67＋/-21.84 mg/L,Hb（126.47 ＋ 14.98）g/L,BTC（5.62 ＋ 0.19）tendency/L difference was not significant,P〉0.05）. Alb,PA,Hb,BTC and 7 d were compared in the 24 h group and 48 h group,and the difference was significant,P〈0.05. Admitted to hospital 24 h,48 h group APTT,PT,the AT-Ⅲ compared with group after 7 d,significant difference,P〈0.05）. The incidence of complications in the 24 h group was 1（3.03%）,the time of bed time（4.89＋0.13）,and the incidence of complications in group d and 48 h were 5（15.15%）,and the bed time（7.05＋0.22）was significantly different,P〈0.05. The incidence rate of A complications in the 24 h group and 48 h group were compared with those in the post-7 d group,and the difference was significant,P〈0.0
作者
夏结婷
李亚洁
张莉
Xia Jieting;Li Yajie;Zhang Li(Nanfang Hospital Affiliated to Nanfang Medical University,Fashan Sanshui District People＇s Hospifo,Foshan 528100,China)
出处
《中国病案》
2018年第7期90-93,共4页
Chinese Medical Record
基金
佛山市自筹经费类科技计划项目(2017AB001265)
关键词
时机
营养
干预
支持
急性脑卒中
Timing
Nutritional
Interventions
Support
Acute stroke
