早期个体化肠内营养在脑卒中后吞咽功能障碍患者中的应用效果  

Effect of early individualized enteral nutrition in patients with swallowing dysfunction after stroke

作　　者：陆春华 王凯 曾贞 孙蕾民[1] LU Chunhua;WANG Kai;ZENG Zhen;SUN Leimin(Department of Gastroenterology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Zhejiang Province,Hangzhou310016,China;Department of Rehabilitation Medicine,Shanghai Fourth Rehabilitation Hospital,Shanghai200040,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院消化科,浙江杭州310016 [2]上海市第四康复医院康复医学科,上海200040

出　　处：《中国医药导报》2021年第35期117-120,137,共5页China Medical Herald

基　　金：上海市卫生和计划生育委员会科研课题计划项目(201540131)。

摘　　要：目的探索早期个体化肠内营养对脑卒中后吞咽功能障碍患者的应用效果。方法前瞻性选取2018年1月至2020年7月上海市第四康复医院收治的脑卒中伴吞咽功能障碍接受鼻胃管管饲患者共125例,按随机数字表法将其分为A组(63例,接受个体化肠内营养支持治疗)和B组(62例,接受家庭自制匀浆膳支持),比较两组治疗30 d后营养状况、并发症及康复疗效。结果治疗30 d后,A组血红蛋白、白蛋白、前白蛋白与治疗前比较,差异无统计学意义(P>0.05),B组血红蛋白、白蛋白、前白蛋白均低于治疗前,且A组高于B组,差异有统计学意义(P<0.05)。A组肺部感染发病率、消化道并发症发生率(胃潴留、便秘、腹泻)低于B组,差异有统计学意义(P<0.05)。治疗30 d后两组患者简式Fugl-Meyer运动功能评分、简易精神状态检查法、改良Barthel指数均高于治疗前,且A组高于B组,差异有统计学意义(P<0.05)。结论根据脑卒中吞咽功能障碍患者病情制订早期个体化肠内营养治疗方案,可有效改善患者营养状况、促进康复、减少肺部感染和胃肠并发症。Objective To explore the effect of early individualized enteral nutrition on patients with swallowing dysfunction after stroke.Methods A total of 125 patients with stroke and swallowing dysfunction who received nasogastric tube feeding in Shanghai Fourth Rehabilitation Hospital from January 2018 to July 2020 were prospectively selected.They were divided into group A(63 cases,received individualized enteral nutrition support)and group B(62 cases,received home-made uniform diet support)according to random number table method.Nutritional status,complications and rehabilitation effect were compared between the two groups after 30 days of treatment.Results After 30 days of treatment,there were no significantly differences in hemoglobin,albumin,and prealbumin in group A compared with before treatment(P>0.05),while hemoglobin,albumin,and prealbumin in group B were lower than those before treatment and the group A were higher than those in group B,the differences were statistically significant(P<0.05).The incidence of pulmonary infection and gastrointestinal complications(gastric retention,constipation,and diarrhea)in group A were lower than those in group B,and the differences were statistically significant(P<0.05).After 30 days of treatment,simplified Fugl-Meyer motor function score,mini-mental state test and modified Barthel index in two groups were higher than before,and group A was higher than group B,and the differences were statistically significant(P<0.05).Conclusion The early individualized enteral nutrition treatment according to the actual condition of the stroke patients with swallowing dysfunction,can effectively improve the patient’s nutritional status,promote recovery,and reduce lung infection and gastrointestinal complications.

关 键 词：脑卒中 个体化肠内营养 营养状况 并发症 康复疗效 

分 类 号：R743[医药卫生—神经病学与精神病学]