急性脑梗死患者早期肠内营养支持治疗效果评价  

Evaluation of early enteral nutrition support in patients with acute cerebral infarction

作　　者：成云芳[1] 戴轶伟[1] CHENG Yunfang;DAI Yiwei(Department of Neurology,the Third People's Hospital of Nantong,Nantong 226001,China)

机构地区：[1]南通市第三人民医院神经内科,江苏南通226001

出　　处：《中国实用神经疾病杂志》2018年第13期1447-1450,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨急性脑梗死患者早期实施肠内营养支持的临床效果。方法选择急性脑梗死伴吞咽障碍患者120例,随机分为对照组及观察组各60例,对照组营养供给为患者家属自制匀浆膳食;观察组于72h内置鼻胃管,使用能全力高能营养素合剂或联合安素供给营养,第1天以30mL/h速度输注,用量500mL,第2天以60~80mL/h速度输注,在第1天的基础上增加250~500mL,直至全量。结果治疗14d后,观察组血红蛋白(HB)、血清白蛋白(ALB)水平、FMA及MMSE评分均高于对照组,NIHSS评分低于对照组(P<0.05),总并发症发生率低于对照组(P<0.05)。结论对伴吞咽障碍患者采用能全力进行肠内营养支持可以提供足够的营养支持,提升ALB及HB水平,改善患者肢体活动功能及认知功能,减轻神经功能缺损,减少各种并发症。Objective To investigate the clinical value of early enteral nutrition support in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction accompanied by dysphagia were selected,including 60 cases in the control group and the observation group,respectively.The nutrition supply of the control group was the home made homogenate diet of the patients'families.The observation group was treated with nasogastric tube and high energy nutrient mixture and/or combined ensure supply of nutrients within 72 hours.At the first day,the infusion speed was 30 mL/h infusion,the dosage was 500 mL;at the second day,the infusion speed was 60 80 mL/h,increased by 250 500 mL than the first day,until the full amount.Results After treatment of 14 days,HB,serum ALB,FMA and MMSE scors in the observation group were higher than those of the control group,NIHSS score was lower than that of control group(P<0.05),the complication in observation group was lower than the control group(P<0.05).Conclusion For patients with dysphagia,using full enteral nutrition support can provide enough nutritional support,improve ALB and HB levels,improve limb movement function,restore cognitive function,reduce neurological impairment and various complications.

关 键 词：急性脑梗死 吞咽障碍 早期 肠内营养 肢体活动功能 认知功能 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]