早期肠内营养对急性脑卒中合并吞咽困难患者康复的影响  

The effect of early enteral nutrition on rehabilitation of acute stroke patients with dysphagia

作　　者：张蓓[1] 李怀苏[1] 兰琳[1] 

机构地区：[1]成都市第二人民医院神经内科,四川成都610017

出　　处：《实用医院临床杂志》2015年第3期112-114,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨早期应用肠内营养对脑卒中合并吞咽困难患者营养状况、并发症及神经功能缺损改善情况的影响。方法收集伴有吞咽障碍的急性脑卒中住院患者70例,按随机数字表法分为两组,两组患者均接受相应的药物治疗和康复治疗,对照组(34例)予以自制流质饮食,试验组(36例)予以肠内营养支持,连续观察30天。观察比较两组患者治疗前后营养指标、并发症及神经缺损的改善情况。结果对照组血清白蛋白(ALB)、血红蛋白(Hb)、上臂三头肌肌围(AMC)及三头肌皮褶厚度(TSF)治疗前后变化差异有统计学意义(P<0.05)。治疗后试验组ALB、Hb、AMC及TSF值均显著高于对照组,神经功能缺损评分(NIHSS)以及肺部感染、腹胀、腹泻、电解质紊乱发生率均显著低于对照组,差异均有统计学意义(P<0.05)。结论早期肠内营养支持能一定程度的改善急性脑卒中患者的营养状态,降低其并发症的发生率,改善其神经功能。Objective To explore the effects of early enteral nutrition on rehabilitation in acute stroke patients with dysphagia . Methods Seventy acute stroke patients with dysphagia were randomly divided into control and experimental groups .The control group （34 cases） was treated with homemade liquid diet while the experimental group （36 cases） was given an enteral nutrition support for 30 days .The nutrient situation ,the adverse reactions and the improvement of function of neurological rehabilitation were recorded and com -pared between the two groups .Results The difference in levels of serum albumin （ALB）,hemoglobin（Hb）,arm muscle circumference （AMC）and triceps skinfold thickness （TST）was statistically significant before and after treatment in the control group （P＜0.05）.Af-ter treatment,the levels of ALB,Hb,AMC and TSF in the experimental group were significantly higher （P＜0.05）while scores of NIH-SS were significantly lower than that in the control group （ P＜0.05 ） .The pulmonary infection ,abdominal distention ,diarrhea ,incidence of electrolyte disorder and overall incidence of complications in the experimental group were significantly lower than that in the control group（P ＜0.05）.Conclusion Early enteral nutrition support can improve the nutritional status ,reduce the incidence of complica-tions and improve the nerve function of the patients .

关 键 词：卒中 早期肠内营养 康复 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R459.3[医药卫生—临床医学]