营养干预辅佐治疗老年脑卒中后遗症患者的疗效观察  

The role of nutritional intervention in neurological rehabilitation of the elderly stroke patients

作　　者：陈跃[1] 章巧云[1] 王九姣[1] 应月华[1] 俞教华[1] 谢光柏[2] 

机构地区：[1]浙江大学医学院附属第一医院分院老干部科,杭州310009 [2]上海第二军医大学附属长征医院康复医学科

出　　处：《中华物理医学与康复杂志》2005年第1期36-39,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：杭州铁路科学技术基金资助项目 (No .B340 30 50 34)

摘　　要：目的　探讨临床营养干预对老年脑卒中后遗症患者营养状况及神经功能康复的影响。方法　将 40例老年脑卒中后遗症住院患者随机分为干预组及对照组。干预组在给予常规药物治疗及康复训练的基础上加用营养干预措施 (包括健康教育、床边营养指导及营养匀浆制剂支持等 ) ;对照组仅给予常规药物治疗及康复训练。分别评估 2组患者治疗前、后的各项生化、免疫指标及体质指数 (BMI)等 ,并观察其在治疗期间的感染发生及神经功能改变情况。结果　 2组患者分别经 3个月干预后 ,发现干预组白蛋白为 (3 9.65±6.11) g/L,血红蛋白为 (12 .68± 1.2 1) g/dl,IgG为 (11.2 8± 2 .61)g/L ,补体C3 为 (0 .84± 0 .11) g/L ,体质指数为 (2 5 .2 6± 3 .81) ,均较对照组 [白蛋白为 (3 7.48± 6.5 7)g/L ,血红蛋白为 (11.72± 1.81) g/dl ,IgG为 (8.5 7±1.98) g/L,补体C3 为 (0 .62± 0 .0 9) g/L ,体质指数为 (2 3 .5 1± 3 .73 ) ]改善明显 ;干预组院内感染发生例次及神经功能缺损评分亦较对照组显著减少。结论　临床营养干预能改善老年脑卒中后遗症患者的全身营养及免疫功能状况 ,具有抑制感染发生、促进神经功能康复等功效。Objective To evaluate the effect of nutritional intervention on neurological rehabilitation of the elderly stroke patients. Methods Forty elderly patients with sequelae of stroke were recruited and randomly divided into two groups (intervention group and control group). Nutritional intervention including patient and caregiver education and nutrient supplement was carried out for three months in intervention group in addition to the conventional pharmacotherapy and rehabilitative training, and only conventional pharmacotherapy and rehabilitative training were given to the patients of the control group. The nutritional status of both groups was examined monthly, and the infectious morbidity and neurological improvement in both groups were also monitored at the same time. Results There were significant differences between the intervention group and the control group with regard to the nutritional status as indicated by various parameters [albumin(39.65±6.11)g/L vs (37.48±6.57)g/L,hemoglobin(12.68±1.21)g/dl vs (11.72±1.81)g/dl,IgG(11.28±2.61)g/L vs (8.57±1.98)g/L,complement C3(0.84±0.11)g/L vs (0.62±0.09)g/L,BMI(25.26±3.81)vs (23.51± 3.73),all P<0.05 or 0.01].Infectious morbidity and neurological deficit score in the intervention group were significantly lower than those in the control group (P<0.05). Conclusion Nutritional intervention could inhibit the morbidity of the infection and promote the neurological rehabilitation in the elderly stroke patients.

关 键 词：营养干预 治疗 脑卒中后遗症 疗效观察 老年人 

分 类 号：R743.3[医药卫生—神经病学与精神病学]