能全力行肠内营养支持配合综合性护理干预对出血昏迷患者的疗效  

Efficacy of enteral nutrition combined with comprehensivenursing in patients with coma due to hypertensive cerebral hemorrhage

作　　者：仲桂英[1] 马丽萍[1] 

机构地区：[1]青海大学附属医院神经内科,青海省西宁市810001

出　　处：《世界华人消化杂志》2014年第19期2795-2799,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨高血压脑出血昏迷患者肠内营养支持的护理的疗效.方法:选择2011-03/2014-02我院接诊的高血压脑出血昏迷的患者120例进行研究.按照随机数表法,将患者随机均分为观察组和对照组.对照组给予混合流质进行鼻饲营养支持,并给予患者一般的护理干预措施.观察组给予能全力进行鼻饲,并采用综合护理干预措施对患者进行护理干预.营养支持4 wk后,监测分析两组患者的总蛋白(total protein,TP)、清蛋白(albumin,ALB)、血红蛋白(hemoglobin,Hb)及淋巴细胞总数(total lymphocyte count,TLC)各营养指标的变化情况.并分析两组患者的预后状况及并发症发生情况.结果:营养支持4 wk后,两组患者的TP、ALB及TLC均明显升高(P<0.05),Hb均无显著性改变(P>0.05);观察组患者营养支持后的TP、ALB及TLC均明显高于对照组(64.31 g/L±4.33 g/L vs 63.10 g/L±3.65 g/L,39.24 g/L±5.45 g/L vs 38.37 g/L±5.49 g/L,17.32×109/L±7.01×109/L vs 15.12×109/L±6.60×109/L,P<0.05).观察组患者的预后效果明显优于对照组,两组患者的预后效果比较有显著性差异(U=-3.0039,P=0.0027).观察组患者的消化系出血、恶心呕吐、便秘及高血糖的发生率明显低于对照组(P<0.05),便秘、腹泻及误吸的发生率无显著性差异(P>0.05).结论:采用能全力进行肠内营养支持,配合综合性护理干预,可显著提高对高血压脑出血昏迷患者的疗效.AIM： To investigate the efficacy of enteral nutri-tion combined with comprehensive nursing in patients with coma due to hypertensive cerebral hemorrhage. METHODS： One hundred and twenty patients with come due to hypertensive cerebral hemor-rhage treated at our hospital from March 2011 to February 2014 were studied. The patients were randomly divided into either an observation group or a control group. The control group was given nasogastric nutrition therapy and routine care intervention. The observation group was given enteral nutrition and comprehensive care intervention. After 4 wk of nutritional therapy, total protein（TP）, albumin（ALB）, hemoglobin（Hb）, and total lymphocyte count（TLC） in the two groups were monitored and analyzed. Theprognosis and complications were compared be-tween the two groups. RESULTS： After 4 wk of nutritional therapy, TP, ALB and TLC significantly increased in both groups（P〈0.05）, but Hb showed no signifi-cant change（P〉0.05）. TP, ALB and TLC were significantly higher in the observation group than in the control group（64.31 g/L ± 4.33 g/L vs 63.10 g/L ± 3.65 g/L, 39.24 g/L ± 5.45 g/L vs 38.37 g/L ± 5.49 g/L, 17.32 × 109/L ± 7.01 × 109/L vs 15.12 × 109/L ± 6.60 × 109/L, P〈0.05）. The prognosis was significantly better in the ob-servation group than in the control group（U =-3.0039, P = 0.0027）. The rates of gastrointestinal bleeding, nausea and vomiting, constipation, and hyperglycemia were significantly lower in the observation group than in the control group（P〈0.05）, but the rates of constipation, diarrhea and aspiration showed no significant difference（P〉0.05）. CONCLUSION： The use of enteral nutritional support with comprehensive nursing interven-tion can significantly improve the efficacy in patients with coma due to hypertensive intrace-rebral hemorrhage.

关 键 词：高血压脑出血 昏迷 肠内营养 护理 

分 类 号：R473.74[医药卫生—护理学]