伴吞咽困难的急性脑卒中患者开展早期肠内营养的临床价值  

Clinical Value of Early Enteral Nutrition in Patients with Acute Stroke Complicated by Dysphagia

作　　者：宋士萍[1] 许明杰[1] 吕莹[1] 

机构地区：[1]北京市垂杨柳医院神经内科,100022

出　　处：《中国全科医学》2010年第14期1505-1507,共3页Chinese General Practice

摘　　要：目的探讨早期规范肠内营养(EN)对伴吞咽困难的急性脑卒中患者预后的影响。方法将108例患者分为营养支持组(58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制剂及普通鼻饲奶。住院第1天和第21天分别检测两组患者的血红蛋白、血清清蛋白、前清蛋白、三酰甘油,统计两组患者第1、21天的NIHSS评分,第7、21天时的感染率及EN胃肠道并发症发生率。结果第21天两组患者的血红蛋白、血清清蛋白、前清蛋白均有下降,对照组下降更为明显(P<0.05);营养支持组第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于对照组(P<0.05);营养支持组NIHSS评分改善更为显著(P<0.01)。结论早期EN可在一定程度上改善伴吞咽困难的急性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 in patients with acute stroke （AS） complicated by dysphagia.Methods One hundred eight patients were divided into groups EN （n=58,given nasogastric feeding of whole protein enteral nutrition preparation） and control （n=50,normal nasal feeding milk）.The levels of hemoglobin （Hb）,serum albumin （Alb）,prealbumin （PA）,triacylglycerol （TG） were determined on days 1,21 of hospitalization,and NIHSS on days 1,21,the infection and the incidence of EN gastrointestinal complications on days 7,21 were calculated.Results The levels of Hb,Alb,PA decreased in 2 groups on days 21,more remarkably in control group （P〈0.05）.The incidence of infection was significantly lower in EN group than in control on days 7,21 （P〈0.05）,but that of EN gastrointestinal complications lower on days 7 （P〈0.05）.NIHSS improved more obviously （P〈0.01）.Conclusion Early EN can improve,to some extent,the nutritional status in AS patients complicated by dysphagia,reduce the incidence of infection and improve prognosis.

关 键 词：卒中 吞咽困难 肠道营养 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]