优质化血糖管理在自发性脑出血危重患者行持续肠内营养中的效果  

High-quality blood glucose management in critical patients with spontaneous intracerebral hemorrhage undergoing continuous enteral nutrition

作　　者：蒋彩霞[1] 张玉敏 侯慧卿[1] 潘宝根[1] 高丽霞[1] 王霞[1] 徐馨 张盼英[1] 孙素娟[1] JIANG Caixia;ZHANG Yumin;HOU Huiqing(Hebei General Hospital,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院,石家庄市050051

出　　处：《河北医药》2023年第2期231-234,共4页Hebei Medical Journal

基　　金：河北省医学科学重点研究课题(编号:20230309)。

摘　　要：目的 探讨自发性脑出血患者行持续肠内营养治疗期间实施优质化血糖管理的效果。方法 选取2020年5月至2021年12月收治的自发性脑出血伴高血糖患者62例,格拉斯哥昏迷评分(GCS评分)≤8分,NRS2002营养风险评分≥3分,接受持续泵入肠内营养治疗的患者作为研究对象,随机分为对照组(给予常规管理)与观察组(给予优质化管理目标血糖7.8~10.0 mmol/L),每组31例,比较2组患者达肠内营养目标喂养热量时间、血糖恢复正常的时间、血清炎性因子白介素-6(IL-6)水平情况及患方对血糖管理的满意度。结果 观察组达肠内营养目标喂养热量时间、血糖恢复正常的时间明显小于对照组(P<0.05);观察组的低血糖发生率与患者满意率显著优于对照组(P<0.05);观察组血清IL-6水平均低于对照组(P<0.05),及治疗前后的差值差异有统计学意义(P<0.05)。结论 自发性脑出血危重患者行持续肠内营养治疗的优质化血糖管理能够显著加快降糖速度,缩短达肠内营养目标喂养热量时间,避免低血糖发生,改善患者机体炎性反应,提高患者方满意度。Objective To explore the effect of high-quality blood glucose management in patients with spontaneous intracerebral hemorrhage(ICH) during continuous enteral nutrition treatment.Methods From May 2020 to December 2021,hyperglycemia patients(n=62) with spontaneous ICH who received continuous enteral nutrition treatment of Glasgow Coma Scale(GCS)≤8 and nutritional risk screening 2002(NRS2002) ≥ 3 were enrolled.The patients were randomized 1∶1 to routine management(the control group) or High-quality blood glucose management(blood glucose target value∶ 7.8~10.0mmol/L,the observation group).The feeding time to enteral nutrition targeted,the recovery time to blood glucose,interleukin-6(IL-6) level,and the satisfaction were included as comparators.Results The feeding time to enteral nutrition targeted and recovery time of blood sugar in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of hypoglycemia and satisfaction rate of patients in the observation group were significantly better than those in the control group(P<0.05).Serum IL-6 levels in the observation group were significantly lower than those in the control group(P<0.05),and the difference was statistically significant in the above indexes between before and after treatment(P<0.05).Conclusion For patients with spontaneous ICH undergoing continuous enteral nutrition,High-quality blood glucose management can significantly accelerate the rate of hypoglycemia,shorten the feeding time to enteral nutrition targeted,avoid hypoglycemia,improve the inflammatory response,and improve the satisfaction.

关 键 词：肠内营养 自发性脑出血患者 应激性高血糖 管理目标血糖 

分 类 号：R743.34[医药卫生—神经病学与精神病学]