营养支持联合早期肺康复锻炼对脑卒中气管切开患者带管时间及复管率的影响  

Effects of nutritional support combined with early pulmonary rehabilitation exercise on the intubation time and reintubation rate of stroke patients with tracheotomy

作　　者：郏丹阳 沈群核 林卫英 JIA Danyang;SHEN Qunhe;LIN Weiying(Intensive-care Unit,Taizhou Hospital of Zhejiang Province,Linhai 317406,Zhejiang,China)

机构地区：[1]浙江省台州医院重症监护室,浙江临海317406

出　　处：《中国现代医生》2023年第9期46-49,56,共5页China Modern Doctor

摘　　要：目的 研究营养支持联合早期肺康复锻炼对脑卒中气管切开患者带管时间及复管率的影响。方法 选取2018年1月至2021年1月浙江省台州医院脑卒中气管切开患者108例,采用随机数字表法分为对照组(常规干预,n=54)和观察组(营养支持联合早期肺康复锻炼,n=54),比较两组患者干预前后的营养指标[血清白蛋白(albumin,ALB)、血清转铁蛋白(transferrin,TRF)、血清前白蛋白(prealbumin,PA)]、肺功能[第1s用力呼气容积(forced expiratory volume in l second,FEV_(1))、用力肺活量(forced vital capacity,FVC)]、炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)]的变化。结果 干预后,观察组患者的带管时间短于对照组(P<0.05),复管率(3.70%)低于对照组(14.81%)(P<0.05);两组干预后的TRF、PA、ALB水平均较干预前明显升高(P<0.05),且观察组明显高于对照组(P<0.05);两组干预后的FVC、FEV1水平较干预前明显升高,且观察组明显高于对照组(P<0.05)。两组干预后的TNF-α、IL-6水平较干预前明显降低(P<0.05),且观察组低于对照组(P<0.05)。结论 脑卒中后行气管切开术患者采用早期肺康复锻炼+肠内营养干预可缩短带管时间,降低复管率,改善营养状况,提高肺功能,减轻炎症反应,值得推广。Objective To study the effect of nutritional support combined with early pulmonary rehabilitation exercise on the intubation time and reintubation rate of stroke patients with tracheotomy.Methods A total of 108 patients with stroke and tracheotomy in Taizhou Hospital of Zhejiang Province from January 2018 to January 2021 were selected and randomly divided into the control group(routine intervention,n=54) and the observation group(nutrition support combined with early pulmonary rehabilitation exercise,n=54).The assisted ventilation conditions of the two groups were compared,and the nutritional status [serum albumin(ALB),transferrin(TRF),prealbumin(PA)] before and after the intervention were compared between the two groups,pulmonary function [forced expiratory volume in 1s(FEV_1),forced vital capacity(FVC)],inflammatory factors [tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)] before and after intervention were compared between the two groups.Results After intervention,the time of intubation in the observation group was shorter than that in the control group(P<0.05),and the reintubation rate(3.70%) was lower than that in the control group(14.81%)(P<0.05).The levels of TRF,PA and ALB in the two groups after the intervention were higher than those before the intervention(P<0.05).The levels of TRF,PA and ALB in the observation group after the intervention were higher than those in the control group(P<0.05).The levels of FVC and FEV1 in the two groups after the intervention were higher than those before the intervention(P<0.05),the levels of FVC and FEV1 in the observation group after the intervention were higher than those in the control group(P<0.05).The levels of TNF-α and IL-6 in the two groups after the intervention were lower than those before the intervention(P<0.05);the levels of TNF-α and IL-6 in the observation group after the intervention were lower than those in the control group(P<0.05).Conclusion Early pulmonary rehabilitation exercise + enteral nutrition intervention for tracheotomy patients after

关 键 词：营养支持 早期肺康复锻炼 脑卒中 气管切开 复管率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]