早期肠内营养乳剂支持疗法治疗重症脑出血患者的临床研究  

Clinical study of early enteral nutrition emulsion support therapy in the treatment of severe cerebral hemorrhage

作　　者：张明[1] 刘逸文[1] 文章[1] ZHANG Ming;LIU Yiwen;WEN Zhang(Department of Critical Care Medicine,West China Hospital of Sichuan University/Nursing School,West China Hospital ofSichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院重症医学科/四川大学华西医院护理学院,四川成都610041

出　　处：《广东药科大学学报》2024年第5期127-131,共5页Journal of Guangdong Pharmaceutical University

摘　　要：目的研究早期肠内营养支持疗法治疗重症脑出血患者的临床疗效及有效性分析。方法选择2021年10月至2023年2月期间于四川大学华西医院住院的108例重症脑出血患者作为研究对象,以随机数字表法分为对照组和观察组,每组各54例。对照组给予一般鼻饲饮食,观察组给予肠内营养乳剂,比较2组营养状况、急性生理与慢性健康评分(APACHEⅡ)、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、肠黏膜屏障功能、免疫指标、并发症发生情况。结果治疗前,2组营养状况[血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)]、APACHEⅡ评分、NIHSS评分、GCS评分、肠黏膜屏障功能[二胺氧化酶(DAO)、D-乳酸(D-LAC)、内毒素(ET)]、免疫指标[免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)]水平比较,差异无统计学意义(P>0.05);治疗2周后,观察组营养状况、APACHEⅡ评分、NIHSS评分、GCS评分、肠黏膜屏障功能、免疫指标水平较对照组更佳,差异有统计学意义(P<0.05);观察组并发症发生率为7.41%,较对照组的29.63%更低,差异有统计学意义(P<0.05)。结论对重症脑出血患者早期给予肠内营养乳剂,能够改善患者的营养状况、肠黏膜屏障功能,增强免疫力,减少并发症,减轻神经功能缺损,促进患者病情恢复,值得推广。Objective To investigate the clinical efficacy and effectiveness of early enteral nutritional support therapy in treating patients with severe cerebral hemorrhage.Methods A total of 108 patients with severe cerebral hemorrhage,hospitalized at West China Hospital of Sichuan University from October 2021 to February 2023,were selected as research subjects.They were randomly divided into a control group and an observation group,each containing 54 cases.The control group was given a general nasal feeding diet,while the observation group received an enteral nutrition emulsion.The nutritional status,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score,intestinal mucosal barrier function,immune indicators,and complications occurrence were compared between the two groups.Results Before treatment,there was no significant difference between the two groups in terms of nutritional status[hemoglobin(Hb),total protein(TP),albumin(ALB)],APACHE II score,NIHSS score,GCS score,intestinal mucosal barrier function[diamine oxidase(DAO),D-lactate(D-LAC),endotoxin(ET)],and immune indicators[immunoglobulin M(IgM),immunoglobulin A(IgA),immunoglobulin G(IgG)]levels(P>0.05).Two weeks after treatment,the observation group showed better nutritional status,APACHE II score,NIHSS score,GCS score,intestinal mucosal barrier function,and immune indicator levels than the control group,with a statistically significant difference(P<0.05).The complication rate in the observation group was 7.41%,significantly lower than the 29.63%in the control group(P<0.05).Conclusion Early administration of enteral nutrition emulsion to patients with severe cerebral hemorrhage can improve their nutritional status and intestinal mucosal barrier function,enhance immunity,reduce complications,alleviate neurological deficits,and promote recovery.This approach is worthy of promotion.

关 键 词：早期肠内营养支持疗法 重症脑出血 营养状况 临床效果 

分 类 号：R743.34[医药卫生—神经病学与精神病学]