早期肠内营养联合肠外营养对急性重症脑卒中患者短期预后的影响  

The short-term prognosis observation of early enteral nutrition combined with parenteral nutrition in the treatment of the severe acute stroke

作　　者：梁晶晶[1] 

机构地区：[1]四川峨眉山市人民医院神经内科

出　　处：《中国实用神经疾病杂志》2015年第17期6-8,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 探讨早期肠内营养联合肠外营养对急性重症脑卒中患者短期预后的影响。方法 选取2012-09—2014-01我院收治的急性重症脑卒中患者99例,按照随机数字表法分为观察组、对照1组和对照2组各33例;其中观察组给予早期肠内营养联合肠外营养,对照组1给予早期肠内营养,对照组2给予常规家庭喂养,观察21d。观察并对比3组治疗前后的营养状况、感染发生率、病死率、神经功能缺损（NIHSS评分）、日常生活能力（ADL评分）、残障程度（mRS评分）。结果 治疗后3组的各营养指标均较治疗前下降,对照组2下降最明显,对照组1次之,观察组下降幅度最小,差异均具有统计学意义（P〈0.05）;治疗后3组的营养不良发生率、感染发生率、病死率、NIHSS评分比较,差异均有统计学意义（χ2=15.628、11.972、8.726,F=7.934,P值分别为=0.006、0.007、0.015,0.009）,而ADL评分比较差异无统计学意义（P〉0.05）;治疗后mRS评分0∽1分、2∽3分构成比差异无统计学意义（P〉0.05）,4∽5分构成比差异有统计学意义（χ2=7.630,P=0.019）。结论 早期肠内营养联合肠外营养能够明显改善急性重症脑卒中患者的营养状况,降低感染发生率,改善患者的短期预后。Objective To explore the short‐term prognosis observation of early enteral nutrition combined with parenteral＆amp;nbsp;nutrition in treatment of the severe acute stroke. Methods 99 cases with acute severe acute stroke from September 2012 to January 2014 were selected and randomly divided into observation group and control group 1 and the control group 2 ,and 33 ca‐ses in each group according to the random number table method. The observation group received early enteral nutrition com‐bined with parenteral nutrition ,the control group 1 received early enteral nutrition ,the control group 2 received conventional family feeding for 21 days. The nutritional status ,the incidence of the malnutrition ,infection ,mortality ,the nerve function defect （NIHSS score） ,daily life ability （ADL score） and degree of disability （mRS score） in the three groups were observed and compared before and after treatment. Results The each nutrition index of the three groups after treatment were decreased compared with before treatment ,the control group 2 had the greatest reduction ,the control group 1 took second place ,the ob‐servation group decreased slightly ,the difference had statistically significance （P 〈0.05） ;All of the malnutrition rate ,infec‐tion incidence ,the mortality and the NIHSS scores in the observation group ,control group 1 and control group 2 after treat‐ment showed statistical differences （χ2 = 15.628 ,11.972 ,15.628 ,F= 7.934 ,P= 0.006 ,0.007 ,0.007 ,0.009） ;The ADL scores of the three groups had no statistical differences （P 〉0.05） ;The constituent ratios of 0 ∽ 1 mRS score ,2 ∽ 3 mRS scores in the three groups after treatment had no statistical difference （P 〉0.05） ,while 4 ∽ 5 mRS scores had a statistically significant difference （χ2 = 7.630 ,P= 0.019）.Conclusion Early enteral nutrition combined with parenteral nutrition can obvi‐ously improve the nutritional status in patients with acute severe stroke ,reduce the infection incidence and improve the

关 键 词：脑卒中 肠内营养 肠外营养 短期预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]