多学科协作营养管理模式在急性脑卒中伴吞咽障碍患者中的应用效果评价  

Evaluation on the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia

作　　者：李宇辉[1] 张静[1] 王颖颖[1] 王变丽[1] 刘骞豪 赵杨[1] 李芳[1] 李程平 Li Yuhui;Zhang Jing;Wang Yingying;Wang Bianli;Liu Qianhao;Zhao Yang;Li Fang;Li Chengping(Department of Neurology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院神经内科,450052

出　　处：《中华临床营养杂志》2021年第1期14-21,共8页Chinese Journal of Clinical Nutrition

基　　金：河南省医学科技攻关计划项目(联合共建)(LHGJ20190412)。

摘　　要：目的评价多学科协作营养管理模式在急性脑卒中伴吞咽功能障碍患者中的应用效果。方法选取2019年2月—2020年2月该院神经内科收治的69例急性脑卒中伴吞咽功能障碍患者,并将其随机分为对照组与研究组,并在研究过程中将不能完成整个研究过程的病例剔除。最终对照组30例患者接受常规营养管理治疗,研究组30例患者接受了多学科协作营养管理模式治疗,对比两组患者入院后第1、7、14 d的血清蛋白、前血清蛋白、血红蛋白、健侧肱三头肌皮褶厚度及上臂肌围等营养指标,并记录两组患者胃肠道并发症发生率及感染并发症的发生率。结果两组患者血红蛋白、健侧肱三头肌皮褶厚度及上臂肌围的比较差异无统计学意义(均P>0.05);研究组患者的血清蛋白及前血清蛋白均高于对照组(均P<0.05),研究组患者的胃肠道并发症发生率低于对照组(P=0.015),研究组患者的感染并发症发生率亦低于对照组(P=0.016)。结论多学科协作营养管理模式应用于急性脑卒中伴吞咽障碍患者,不仅有利于改善患者营养状况,亦有助于降低胃肠道并发症发生率及感染并发症的发生率,具有一定的临床推广及应用价值。Objective To analyze the effects of multidisciplinary cooperative nutrition management model in acute stroke patients with dysphagia.Methods From February 2019 to February 2020,69 acute stroke patients with dysphagia were enrolled in this study.After exclusion of those unable to complete the trial,patients were randomized into control group(n=30)and experimental group(n=30).Patients in the control group were given routine nutrition management,while patients in the experimental group were treated under multidisciplinary cooperative nutrition management model.Nutritional indicators were compared between the two groups on Day 1,7 and 14 after admission,including levels of albumin(ALB),pre-albumin(PALB),hemoglobin(HB),triceps skin-fold(TSF)thickness on the uninjured side,upper arm muscle circumference etc.Incidence of gastrointestinal complications and infectious complications was also recorded.Results There was no difference between two groups in the levels of HB,TSF thickness and upper arm muscle circumference on the uninjured side(all P>0.05).However,the serum levels of ALB and PALB on Day 7 and 14 in the experimental group were higher than that in the control group(all P<0.05),The incidence of gastrointestinal complications(P=0.015)and infectious complications(P=0.016)in the experimental group was lower than that in the control group.Conclusion Multidisciplinary collaborative nutrition management improved nutritional indicators,reduced the incidence of gastrointestinal complications and infectious complications in acute stroke patients with dysphagia,making multidisciplinary collaborative nutrition management model worthy of clinical promotion and application.

关 键 词：多学科协作 营养管理 急性脑卒中伴吞咽障碍 应用效果 

分 类 号：R473.74[医药卫生—护理学]