脑卒中术后病人个体化肠内营养支持的临床效果观察  

Clinical research of individualized enteral nutritional support in stroke patients after surgery

作　　者：潘丹峰[1] 周锦扬[1] 

机构地区：[1]广州市第一人民医院营养科,广东广州510180

出　　处：《肠外与肠内营养》2015年第2期98-100,106,共4页Parenteral & Enteral Nutrition

摘　　要：目的：探讨个体化肠内营养（EN）支持对脑卒中颅脑手术后病人的临床效果. 方法：将62例因脑血管意外行颅脑外科手术后需营养支持的病人随机分为两组,试验组33例给予个体化EN支持,根据病情给予不同配方、浓度的EN液,必要时添加营养组件;常规组29例给予标准配方的整蛋白EN液.两组热量供给均为104.6～ 125.5 kJ（25～30 kcal）/（kg＆#183;d）.检测营养支持前和营养支持3周后血清清蛋白（ALB）、前清蛋白（PA）、血红蛋白（Hb）、淋巴细胞计数（LY）、C反应蛋白（CRP）水平,观察胃肠道不良反应发生情况,记录住院天数. 结果：营养支持3周后,试验组病人血清ALB、PA明显升高,CRP明显降低,与常规组比有显著性差异（P＜0.05）.试验组病人的胃肠道不良反应发生率明显低于常规组,住院天数少于常规组（P＜0.05）. 结论：个体化营养支持更有利于改善脑卒中术后病人的营养状况,降低炎性反应,减少胃肠道不良反应的发生率.Objective： To evaluate the effect of individualized enteral nutritional （EN） support （intervention group） in postoperative stroke patients. Methods： 62 stroke patients after cerebral sur- gery at nutritional risk were randomized to either individualized EN support or routine EN support. Pa- tients in the intervention group received an individualized EN with different formula and concentration ac- cording to the clinical status. In routine group, patients received EN of constant formula. Blood albumin, prealbumin, hemoglobin, C-reactive protein （CRP） were examined before and after three weeks＇ EN. The gastrointestinal（GI） complications were observed during EN. Results ： The levels of albumin and pre- albumin were higher in intervention group than routine group （P 〈 0.05 ） . The levels of CRP were lower in intervention group （P 〈 0.05 ） . The incidence of GI complications was lower than routine group. And lengths of hospital stay were shorter than routine group （ P 〈 0.05 ）. Conclusion ： Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammative reaction and reduced GI complications in postoperative stroke patients.

关 键 词：脑卒中 肠内营养 C反应蛋白 

分 类 号：R651.12[医药卫生—外科学] R459.3[医药卫生—临床医学]