早期免疫肠内营养支持对重症脑卒中患者营养状况、免疫功能及预后的影响  

Effect of early enteral nutrition support on nutritional status,immune function and prognosis for patients with severe stroke

作　　者：喻小玲[1] 周仕钧[1] 彭海峰[1] 杨旭波[1] 唐海洋[1] 

机构地区：[1]湖南省湘潭市第一人民医院神经内科,411101

出　　处：《疑难病杂志》2014年第11期1114-1117,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析早期应用免疫肠内营养支持治疗对重症脑卒中患者营养状况、免疫功能及预后的影响。方法将66例重症脑卒中患者按数字表格法随机分为2组,每组33例。在常规治疗的基础上,对照组给予普通流质饮食鼻饲,观察组给予肠内营养支持治疗,治疗15 d后比较2组患者的营养情况、免疫功能及预后。结果治疗第15天,营养指标:对照组血清总蛋白(TP)、白蛋白(Alb)、前白蛋白(PA)、血红蛋白(Hb)分别为(61.42±3.34)g/L、(34.04±3.92)g/L、(226.3±17.5)mg/L、(111.7±12.8)g/L,观察组分别为(67.16±4.41)g/L、(37.46±3.25)g/L、(278.6±16.1)mg/L、(127.4±13.3)g/L;免疫功能指标:对照组IgG、IgM、IgA、CD4、CD8、CD4/CD8分别为(13.04±1.24)g/L、(1.78±0.43)g/L、(2.37±0.76)g/L、(36.92±1.94)%、(25.79±1.88)%、1.27±0.12;观察组分别为(16.49±1.16)g/L、(2.32±0.31)g/L、(2.84±0.53)g/L、(41.16±2.01)%、(27.84±1.93)%、1.56±0.19,2组患者各项指标均有降低.且对照组较观察组下降显著(P<0.05)。并发症:对照组患者肺部感染、心力衰竭、压疮、肾衰竭、尿路感染、应激性溃疡发生率分别为24.2%、18.2%、21.2%、15.2%、18.2%、36.4%,观察组分别为12.1%、9.1%、9.1%、6.1%、6.1%、24.2%,观察组低于对照组但差异无统计学意义(P>0.05)。结论应用早期肠内营养支持可明显改善重症脑卒中患者的预后,有效纠正低蛋白血症,提高机体免疫力,并减少并发症的发生。Ob jective To analyze the early applications of immune enteral nutrition support treatment effect on nutri -tional status, immune function and prognosis of patients with severe stroke .Methods Sixty-six cases of severe stroke patients were randomly divided into 2 groups by digital table method , 33 cases in each group .On the basis of conventional therapy , the control group was given common liquid diet feeding;the observation group was given enteral nutrition support treatment , im-mune function , nutritional condition and prognosis of the patients in the 2 groups after 15 d treatment were compared .Results On the fifteenth days of treatment, nutrition indicators revealed： serum total protein （TP）, albumin （Alb）, prealbumin （PA）, hemoglobin （Hb） in control group were （61.42 ±3.34） g/L,（34.04 ±3.92） g/L,（226.3 ±17.5） mg/L,（111.7 ± 12.8） g/L, the observation group were （67.16 ±4.41） g/L,（37.46 ±3.25） g/L,（278.6 ±16.1） mg/L, （127.4 ±13.3） g/L;immune function index：control group’s IgG, IgM, IgA, CD4, CD8, CD4/CD8 were （13.04 ±1.24） g/L, （1.78 ± 0.43） g/L, （2.37 ±0.76） /L,（36.92 ±1.94）%, （25.79 ±1.88）%, （1.27 ±0.12）;observation group were （16.49 ± 1.16） g/L, （2.32 ±0.31） g/L, （2.84 ±0.53） g/L, （41.16 ±2.01）%, （27.84 ±1.93）%, （1.56 ±0.19）, the index of both groups were decreased, but in control group decreased significantly than those in the observation group （P 〈0.05）. Complications：control group patients ’ pulmonary infection, heart failure, renal failure, pressure ulcers, urinary tract infec-tion, stress ulcer occurred rate were 24.2%, 18.2%, 21.2%, 15.2%, 18.2%, 36.4%, respectively, in the observation group were 12.1%, 9.1%, 9.1%, 6.1%, 6.1%, 24.2%, which were lower than that of control group , but no significant difference was observed between two groups （ P 〉0.05）.Conclusion The application of early enteral nutrition support can improve the prognosis of patients with severe st

关 键 词：脑卒中 肠内营养支持 营养状况 免疫功能 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]