肠内营养支持对急性重症脑卒中患者预后的影响  

Effect of enteral nutrition support on prognosis in patients with severe acute stroke

作　　者：李美英[1] 夏峰[1] 苏建华[1] 丁绍青[1] 

机构地区：[1]东南大学医学院附属马鞍山市人民医院神经内科,马鞍山243000

出　　处：《临床神经病学杂志》2008年第3期171-173,共3页Journal of Clinical Neurology

摘　　要：目的探讨肠内营养支持对急性重症脑卒中患者预后的影响。方法将54例急性重症脑卒中患者随机分为营养支持组（30例）和对照组（24例）,在常规治疗的基础上,分别给予能全力高能营养素合剂及普通流汁鼻饲。住院第1d、10d和21d分别检测两组患者血红蛋白、血清白蛋白、三酰甘油水平、美国国立卫生院卒中量表（NIHSS）评分,统计感染发生率;入院30d时进行日常生活能力量表（ADL）评定和分级。结果住院第10d、21d两组患者各项营养指标均下降,对照组下降更为明显（均P〈0.05）;对照组第10d、21d低蛋白血症发生率及感染发生率显著升高（均P〈0.05）;营养支持组第10d、21d感染发生率显著低于对照组（均P〈0.05）。第21d两组NIHSS评分均有明显改善,营养支持组较对照组同期改善更为显著（均P〈0.05）,第30d时临床痊愈率（ADLⅠ,23%）及与日常生活自理率（ADLⅠ-Ⅲ,86%）显著高于对照组（12%,66%）（均P〈0.05）。结论早期肠内营养支持可明显改善重症脑卒中患者的营养状况,降低感染的发生率,改善预后。Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke. Methods 54 cases of severe acute stroke were divided into nutrition-supported group（30 cases） and control group （24 cases ） randomly. All patients were treated by conventional therapy. Nutrition-supported group received high-energy nutrition diet and control group received common liquid diet by nasal feeding. The levels of hemoglobin, serum albumin, prealbumin, triacylglycerol, neurologic impairment score （NIHSS） , the incidence rates of hypoproteinemia and infective complications were assessed at the 1st d,the 10th d and the 21st d after admission. Activity of daily living （ADL） was also observed at the 30th d after admission. Results The nutrition indeces in both groups were descend at the 10th d and the 21st d after admission in both groups, and there were significantly lower in the control group than those in nutrition-supported group （all P 〈 0. 05 ）; the incidence rates of hypoproteinemia and infection complications in the control group were obviously higher at the 10th d and the 21st d （all P 〈 0. 05 ）. However, the incidence rates of infective complications in nutrition-supported group were lower significantly than those in the control group at the 10th d and the 21st d（ all P 〈 0.05 ）. NIHSS in both groups were improved at the 21st d, while more significantly in nutrition-supported group （ all P 〈 0.05 ）. At the 30th d ,the rates of cure and take care on oneself in nutrltion-supported group（ ADL Ⅰ ,23% ; ADL Ⅰ - Ⅲ ,86% ） were significantly higher than those in the control group（ 12% ,66% ） （ all P 〈 0.05 ）. Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of infective complications in patients with severe acute stroke, and helpful for clinical prognosis.

关 键 词：肠内营养 脑卒中 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]