急性重症脑卒中患者早期肠内营养支持治疗的体会  

Experience of Early Enteral Nutrition Support in Patients With Severe Acute Cerebral Stroke

作　　者：宋士萍[1] 李莉莉[1] 吕莹[1] 

机构地区：[1]北京市垂杨柳医院,北京100022

出　　处：《内科急危重症杂志》2010年第2期70-72,80,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨早期规范肠内营养(EN)对急性重症脑卒中预后的影响。方法:将106例患者分为营养支持组(56例)和对照组(50例),在常规治疗的基础上,分别给予鼻饲整蛋白肠内营养素制剂及普通鼻饲奶。入院第1、14和21天分别检测两组的血红蛋白、血清白蛋白、前白蛋白、甘油三酯,统计两组第1、21天NIHSS评分、第7、21天时的感染及EN胃肠道并发症的发生率。结果:第14、21天两组各项营养指标均有下降,对照组下降更为明显(P<0.05);肠内营养组第7、21天感染发生率显著低于对照组(P<0.05),但第7天EN胃肠道并发症的发生率高(P<0.05)。两组NIHSS评分均有明显改善,肠内营养组改善更为显著(P<0.05)。结论:早期EN可明显改善重症脑卒中患者的营养状况,降低感染发生率,改善预后。Objective： To investigate the effect of early standard enteral nutrition （EN） support on prognosis of patients with severe acute cerebral stroke. Methods： One hundred and six cases were divided into nutrition supported group （56 cases） and control group （50 cases） randomly. All patients were treated by conventional therapy. Patients in nutrition supported group received entire protein-based enteral nutrition preparations and control group received common feeding-mixed milk by nasogastric feeding. The levels of hemoglobin, serum albumin, prealbumin, triglyceride were assessed at the 1st, 14th and 21st day after admission, Neurologic impairment score （NIHSS） were assessed at the 1st and the 21st day after admission, and the incidence of infection and complications of gastrointestinal tract at the 7th and the 21st day of the two groups were also compared. Results： The nutrition index in both groups were descend at the 14th and the 21st day after admission, while more significantly descended in control group （P〈0. 05）. The incidence of infection at the 7th and the 21st day in nutrition supported group were obviously lower than those in control group （P〈0. 05）, but the incidence of complications of gastrointestinal tract at the 7th day were higher （P〈0. 05）. The score of NIHSS in both groups were improved at the 21st day, while more significantly in nutrition supported group （P〈0. 05）. Conclusions： Early EN can significantly improve nutritional status and decrease the incidence of infection in patients with severe acute cerebral stroke,and improve prognosis.

关 键 词：脑卒中 肠内营养 腹胀 腹泻 

分 类 号：R459.3[医药卫生—治疗学] R743.3[医药卫生—临床医学]