急性卒中伴吞咽困难患者序贯联用肠内外营养的临床研究  

Clinical study on sequential combined enternal and parenteral nutrition in patients with acute stroke complicatel with dysphagia

作　　者：崔赢[1] 明宝红 金娜[1] 胡乐 李璐[1] CUI Ying;MING Bao-hong;JIN Na;HU Le;LI Lu(Second Department of Neurology,Shengjing Hospital of China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院第二神经内科,沈阳110022

出　　处：《实用药物与临床》2018年第10期1152-1154,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨肠内、肠外营养单用或肠内外序贯联合对急性脑卒中伴吞咽困难患者营养状况及住院时间的影响。方法选取2015年1月至2018年1月我院第二神经内科收治的136例急性脑卒中患者,将其随机分为3组。肠内营养组(肠内组) 45例,单用肠内营养支持;肠外营养组(肠外组) 45例,单用肠外营养支持;序贯联合组(序贯组) 46例,肠内联合肠外序贯营养支持。治疗7 d后,观察比较三组患者的营养状况、并发症以及住院时长。结果治疗后,三组患者营养指标(血红蛋白、白蛋白、上臂三头肌肌围水平)均低于治疗前(P <0.05),且肠内组低于肠外组和序贯组,肠外组低于序贯组(P <0.05)。肠外组患者肺部感染、消化道溃疡、腹胀、电解质紊乱等并发症发生率显著高于肠内组和序贯组,差异有统计学意义(P <0.05),而肠内组与序贯组比较差异无统计学意义(P> 0.05)。肠内组患者住院时间长于肠外组和序贯组,肠外组长于序贯组,差异有统计学意义(P <0.05)。结论肠内联合肠外序贯营养支持与单用肠内或肠外营养比较,营养指标下降幅度低,并发症发生率低,且住院时长短于肠内组及肠外组。Objective To investigate the effects of enteral and parenteral nutrition alone or sequential combination of enteral and parenteral nutrition on nutritional status and hospitalization time in patients with acute stroke complicated with dysphagia. Methods Totally 136 patients with acute stroke admitted to the second neurology department of our hospital from January 2015 to January 2018 were randomly divided into three groups. Enteral nutrition group （ enteral group, n = 45 ） was given enteral nutrition only ;parenteral nutrition group （ parenteral group, n = 45 ） was given parenteral nutrition only ; sequential combination group （ sequential group, n = 46 ） was given enteral combined with parenteral nutrition support sequentially. After 7 days of treatment, the nutritional status,complications and hospitalization time in the three groups were observed and compared. Results After treatment,the nutritional indexes （hemoglobin, albumin and triceps muscle circumference） of the three groups were decreased （P 〈 0. 05 ） ;those in enteral group was the lowest （ P 〈 0. 05 ） ; the indexes in parenteral group was lower than those of sequential group （ P 〈 0. 05 ）. The incidence rates of pulmonary infection,gastrointestinal ulcer,abdominal distention and electrolyte disturbance in parenteral group were significantly higher than those in enteral group and sequential group （ P 〈 0. 05 ） , but there was no significant difference between enteral group and sequential group （ P 〉 0. 05 ）. The hospitalization time in enteral group was longer than that of parenteral group or sequential group, and that in sequential group was the shortest（ P 〈 0. 05 ）. Conclusion Compared with enteral or parenteral nutrition alone, enteral nutrition combined with parenteral nutrition has a lower decrease in nutritional parameters,a lower incidence of complications and a longer hospital stay than enteral and parenteral nutrition alone.

关 键 词：急性脑卒中 肠内营养 肠外营养 序贯联合营养支持 

分 类 号：R743.3[医药卫生—神经病学与精神病学]