肠内营养液对急性脑出血吞咽障碍患者营养状况及感染的影响  

Influence of enteral nutrition on nutrition status and incidence of infections in acute cerebral hemorrhage patients with dysphagia

作　　者：申林[1] 李杰 郑平[3] 

机构地区：[1]天津市泰达医院营养科,天津300457 [2]天津市汉沽医院ICU,天津300170 [3]天津市第三中心医院营养科,天津300480

出　　处：《中华医院感染学杂志》2014年第5期1163-1165,共3页Chinese Journal of Nosocomiology

基　　金：天津市高等学校科技发展基金项目(20020225)

摘　　要：目的探讨肠内营养液对急性脑出血吞咽障碍患者的营养状况影响,并分析肠内营养液对该类患者感染的发生率。方法选取2011年9月-2013年8月急性脑出血吞咽障碍患者86例,随机分为试验组与对照组,每组各43例,试验组患者给予持续肠内混悬营养液,对照组患者给予自制的普通流质食物,并通过分次推注鼻饲;治疗前、治疗后3、5周分别抽取两组患者的静脉血,进行血红蛋白、血清白蛋白、IgG、IgA及IgM检测,并记录两组患者在治疗期间发生感染率,采用SPSS19.0统计软件对所有数据进行统计分析。结果治疗前两组患者的营养和免疫指标的比较差异无统计学意义,治疗3周及5周时,试验组患者的血红蛋白及血清白蛋白明显高于对照组(P<0.05),试验组IgG、IgA及IgM比对照组高,但只有IgG在治疗5周时差异有统计学意义(P<0.05);治疗期间试验组患者感染率46.5%,对照组67.4%,试验组患者感染率明显比对照组低,差异有统计学意义(P<0.05),试验组肺部及尿路感染率分别为25.6%及16.3%,均比对照组的34.9%及20.9%低,但差异无统计学意义。结论肠内营养混悬液可以改善脑出血吞咽障碍患者的营养状况,并可降低急性脑出血吞咽障碍患者感染的发生率。OBJECTIVE To explore the influence of enteral nutrient solution on the nutrition status of the acute cerebral hemorrhage patients with dysphagia as well as the incidence of infections. METHODS A total of 86 cases of acute cerebral hemorrhage with dysphagia, who were treated in the hospital from Sep 2011 to Aug 2013, were enrolled in the study and randomly divided into the experimental group and the control group, with 43 cases in each, then the experimental group was given the continuous enteral nutrient solution, the control group was treated with homemade ordinary liquid food, and the nasogastric feeding was injected; the venous blood was sampled from the two groups of patients before the treatment or 3 or 5 weeks after the treatment for the detection of hemoglobin, serum albumin, IgG, IgA, or IgM; the incidence of infections that occurred during the treatment was recorded, and all the data were statistically analyzed with the use of SPSS19. 0 software. RESULTS Before the treatment, the difference in the nutrition or immunization indicators between the two groups was not statistically significant; at the third or fifth week of treatment, the levels of the hemoglobin and serum albumin of the experimental group were significantly higher than those of the control group（P〈0. 05）; the levels of IgG, IgA, and IgM of the experimental group were higher than those of the control group, however, the difference in the level of IgG at the fifth week of treatment was statistically significant （P 〈 0. 05）. During the treatment, the infection rate was 46. 5 % in the experimental group, significantly lower than 67. 4 % in the control group, the difference was statistically significant; the incidence of pulmonary infections was 25. 6 % in the experimental group. lower than 34. 9 % in the control group. the incidence of urinary tract infections was 16. 3 % in the experimental group. lower than 20. 9 % in the control group. but the differences were not statistically significant. CONCLUSION The enteral nutrient solutio

关 键 词：肠内营养混悬液 急性脑出血吞咽障碍 感染 

分 类 号：R181.32[医药卫生—流行病学]