两种鼻饲法用于急性脑卒中吞咽障碍患者的效果观察  

Effect of two kinds of nasal feeding in acute stroke patients with dysphagia

作　　者：沈卫红[1] 沈英[1] 王吉平[1] 李丽[1] 王子高[1] 谭丽萍[1] 陈燕[1] 

机构地区：[1]复旦大学附属金山医院神经内科,201508

出　　处：《神经疾病与精神卫生》2015年第3期289-292,共4页Journal of Neuroscience and Mental Health

基　　金：基金项目：复旦大学附属金山医院院级课题（2013-20）

摘　　要：目的：探讨不同的鼻饲方法对急性脑卒中合并吞咽障碍患者的临床应用效果。方法选择急性脑卒中合并吞咽障碍患者80例，随机分为对照组和观察组各40例。两组均采用瑞代肠内营养乳剂，对照组采用手工分次分量推注鼻饲喂养方法，观察组采用恒温点滴间断滴注的方法。观察两组的营养、炎症指标的变化以及并发症的发生率。结果对照组治疗3周后，血清白蛋白、前白蛋白、血尿素氮、血肌酐较治疗前明显下降（P ＜0．05），炎性指标CRP明显高于治疗前（P ＜0．01）；观察组治疗3周后，血清白蛋白、前白蛋白明显高于治疗前（P ＜0．01），而血尿素氮、血肌酐无明显变化（P ＞0.05），CRP水平高于治疗前（P ＜0．01）；治疗3周末，对照组血白蛋白、前白蛋白、血尿素氮、血肌酐明显低于观察组（P＜0．01），而CRP明显高于观察组（P＜0．05）。观察组呕吐返流、误吸、肺部感染的发生率明显低于对照组（P ＜0．05）。结论对于急性脑卒中合并吞咽障碍患者，采用恒温点滴间断滴注的鼻饲方法，能有效保证营养供给和减少并发症的发生率。Objective To observe the clinical effect of two kinds of nasal feeding in acute stroke patients with dysphagia .Methods Eight patients of acute stroke with dysphagia were randomly divided into the observation group and the control group ,with 40 cases in each group .Two groups all used enter‐al nutrition emulsion named Ruidai .The patients in the control group used manual fractional component pushed nasal feeding ,While the patients in the observation group used constant temperature drops contin‐uously drip nasal feeding .Observe the change of the two groups of nutrition ,inflammation ,and the inci‐dence of complications .Results After the treatment of the control group for 3 weeks ,serum albumin , prealbumin ,blood urea nitrogen ,serum creatinine were obviously descended than before treatment （P〈0 .05） ,CRP was significantly higher than the before treatment （P 〈 0 .01）;After the treatment of the observation group for 3 weeks ,serum albumin ,prealbumin was significantly higher than before treat‐ment （P〈 0 .01） ,the blood urea nitrogen and serum creatinine were almost the same （P〉 0 .05） .After the treatment of the observation group and the control group for 3 weeks ,the control serum albumin , prealbumin , blood urea nitrogen , serum creatinine were significantly lower than the observation group （P 〈 0 .01） ,CRP was significantly higher than the observation group （P〈 0 .05） .The incidence of vomiting ,regurgitation ,aspiration ,pulmonary infection in the observation group were significantly lower than that of the observation group （P 〈 0 .05） .Conclusions For the acute stroke patients with dysphagia ,using constant temperature drops continuously drip nasal feeding method can effectively guar‐antee the nutrition supply and reduce the incidence of complications .

关 键 词：急性脑卒中 吞咽障碍 恒温点滴间断滴注法 并发症 

分 类 号：R743.74[医药卫生—神经病学与精神病学]