鼻饲时机对急性前循环大动脉闭塞性脑梗死血管内治疗后卒中相关肺炎的影响  

Effect of nasal feeding timing on stroke-related pneumonia after intravascular therapy for acute anterior circulation main artery occlusive cerebral infarction

作　　者：方敏[1] 干克娜[1] 刘卉[1] 曾宏亮[1] 罗征进 FANG Min;GAN Kena;LIU Hui;ZENG Hongliang;LUO Zhengjin(Department of Neurology,Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]江西省赣州市人民医院神经内科,江西赣州341000

出　　处：《中国当代医药》2024年第12期36-39,43,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212424)。

摘　　要：目的探讨鼻饲时机对急性前循环大动脉闭塞性脑梗死血管内治疗后卒中相关肺炎的影响。方法选择2021年1月至2022年1月赣州市人民医院收治的90例急性前循环大动脉闭塞性脑梗死患者作为研究对象,按照随机数字表法分为A组(n=30)、B组(n=30)和C组(n=30),三组分别于术前,术后1、24 h留置胃管,比较三组并发症发生率、美国国立卫生研究所脑卒中(NIHSS)评分及改良Rankin(mRS)评分。结果A组肺部感染发生时间短于B组、C组,差异有统计学意义(P<0.05);A组肺部感染、消化道出血及低蛋白血症发生率低于B组和C组,差异有统计学意义(P<0.017)。三组入院第7天NIHSS评分比较,差异无统计学意义(P>0.05),入院3个月A组NIHSS评分均低于B组、C组,差异有统计学意义(P<0.05);A组入院3个月mRS评分均低于B组、C组,差异有统计学意义(P<0.05)。结论急性前循环大动脉闭塞性脑梗死血管内治疗时,于手术前开展鼻饲,能够降低肺部感染相关发生率,有助于促使患者神经功能恢复,改善生活状态,整体应用效果较好,值得推广应用。Objective To investigate the effect of nasal feeding timing on stroke-related pneumonia after intravascular therapy for acute anterior circulation main artery occlusive cerebral infarction.Methods A total of 90 patients with acute anterior circulation main artery occlusive cerebral infarction admitted to the Ganzhou People's Hospital from January 2021 to January 2022 were selected as the study objects,they were divided into group A(n=30),group B(n=30)and group C(n=30)according to random number table method.Gastric tubes were placed in all three groups before,1 and 24 h after surgery.The incidence,National Institutes of Health stroke scale(NIHSS)score and modified Rankin scale(mRS)score were compared among the three groups.Results The occurrence time of pulmonary infection in group A was shorter than that in group B and group C,and the difference was statistically significant(P<0.05).The incidence of pulmonary infection,gastrointestinal hemorrhage and hypoproteinemia in group A were lower than that in group B and group C,and the differences were statistically significant(P<0.017).There was no significant difference in NIHSS score on the 7 d after admission among the three groups(P>0.05).NIHSS score of group A was lower than that of group B and group C after 3 months of admission,and the difference was statistically significant(P<0.05).The mRS score of group A at 3 months after admission was lower than those of group B and group C,and the difference was statistically significant(P<0.05).Conclusion In the endovascular treatment of acute anterior circulation great artery occlusive cerebral infarction,nasal feeding before operation can reduce the incidence of lung infection,help to promote the recovery of neurological function and improve life status of patients,and the overall application effect is good,worthy of promotion and application.

关 键 词：鼻饲时机 急性前循环大动脉闭塞性 脑梗死 卒中相关肺炎 

分 类 号：R743[医药卫生—神经病学与精神病学]