序贯肠内营养对急性脑梗死患者营养状况和预后的影响  

Influence of sequential enteral nutrition on nutritional status and prognosis in patients with acute cerebral infarction

作　　者：朱蓓蕾[1] 邵蓓[1] 王贞[1] 余震[1] 冯靓[1] 殷为勇[1] 张征[1] 

机构地区：[1]温州医学院附属第一医院脑血管科,325000

出　　处：《临床神经病学杂志》2009年第5期337-339,共3页Journal of Clinical Neurology

摘　　要：目的探讨序贯肠内营养对急性脑梗死（ACI）患者营养状况及预后的影响。方法将80例ACI伴吞咽障碍患者分为序贯肠内营养组和对照组,各40例。肠内营养组患者给予短肽型肠内营养制剂（总量按每天84-126 kJ/kg）鼻饲3 d,第4 d起改用整蛋白型肠内营养制剂鼻饲;对照组给予普通流质食物鼻饲;均持续≥10 d。观察两组患者营养治疗第1 d、7 d、14 d的营养指标[三头肌皮褶厚度（TSF）、上臂三头肌肌围（MAMC）、血清白蛋白（Alb）、血清前白蛋白（PAB）、血红蛋白（Hb）含量]、感染并发症发生率及美国国立卫生研究院卒中量表（NIHSS）评分和Barthel指数（BI）。结果肠内营养组在治疗后第14 d营养指标（TSF、MAMC、血清Alb、血清PAB、Hb含量）明显高于对照组（P〈0.05-0.01）;感染并发症的发生率明显低于对照组（P〈0.05）;肠内营养组治疗后第14 d NIHSS评分明显低于对照组,BI值明显高于对照组（均P〈0.05）。结论序贯肠内营养治疗能够改善ACI患者的营养状况,降低感染性并发症的发生率,改善患者的近期预后。Objective To explore the influence of the sequential enteral nutrition （SEN） on nutritional status and prognosis in patients with acute cerebral infarction（ACI）. Methods 80 ACI patients complicated with dysphagia were divided into SEN group and control group（40 cases in each group）. In the first three days patients in SEN group were treated with nasal feeding short-peptide enteral nutrition[ 84 - 126（ kJ/kg·d）] ,than,which would be replaced with nasal feeding integral-protein enteral nutrition from the forth day. Patients in the control group were provided with ordinary fluid food by nasal feeding. Nutrition support for both groups was at last more than 10 d. In the 1 d, 7 d and 14 d after treatment, data of both groups concerned with triceps skin fold （TSF）, mean upper arm muscle circumference of triceps（MAMC）, serum albumen（Alb） , serum prealbum（PAB） , heamoglobin（Hb） , incidence of infectious complications, National Institutes of Health Stroke Scale （NIHSS） score and Barthel index （BI） were examined. Results Nutritional indexes （TSF, MAMC, Alb, PAB, Hb） in the SEN group were significantly higher than those in the control group （ P 〈 0.05 - 0.01 ） at 14 d after treatment. The rate of infectious complications in the SEN group was significant decreased compared to the control group （P 〈 0.05）. Compared with the control group, the NIHSS score was significantly lower and BI was significantly higher in the SEN group at 14 d after treatment （ all P 〈 0.05）. Conclusion The SEN can improve the nutritional status in patients with ACI and decrease the rate of infections complication, and improve the short-term prognosis.

关 键 词：急性脑梗死 序贯肠内营养 营养状况 预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]