早期肠内营养支持治疗急性脑卒中的效果观察

摘要

Objective To explore the effect of early enteral nutritional support in the treatment of acute cerebral stroke. Methods 92 acute cerebral stroke patients with dysphagia from January 2008 to July 2014 in our hospital were select-ed and randomly divided into the observation group (52 cases) and the control group (40 cases).The observation group was given nasogastric enteral nutritional support within 72 hours after admission,the control group was fed by their families.Nutritive indexes such as arm muscle circumference (AMC),total lymphocyte count (TLC),serum albumin (Alb), prealbumin (PA),hemoglobin (Hb) in two groups was compared.The incidence rate of hypoproteinemia (serum albumin less than 35 g/L),the incidence rate of infected complication,neurologic impairment degree (NIHSS score) and activity of daily living (Barthel index) in two groups was compared. Results The level of AMC,TLC,Alb,PA and Hb after treatment in the observation group was higher than that before treatment and in the control group after treatment,with significant difference (P<0.05).The incidence rate of infection and hypoproteinemia in the observation group was lower than that in the control group,with significant difference (P<0.05).The score of NIHSS in the observation group after treatment was lower than that in the control group after treatment,with significant difference (P<0.05).The score of Barthel index in the observation group after treatment was higher than that in the control group after treatment,with significant difference (P<0.05). Conclusion Early enteral nutritional support in patients with acute cerebral stroke can effectively improve the nutritional status,enhance immunity,promote recovery of neurological function,reduce the incidence rate of infection,and improve patient’s early prognosis.%目的：探讨早期肠内营养支持治疗急性脑卒中的效果。方法选取2008年1月~2014年7月本院收治的92例急性脑卒中伴吞咽障碍患者作为研究对象，随机分为观察组（52例）和对照组（40例）。观察组于入院后72 h内给予鼻饲肠内营养支持，对照组采用家庭喂养饮食。比较两组的上肢中臂肌围（AMC）、总淋巴细胞计数（TLC）、血清白蛋白（Alb）、前白蛋白（PA）与血红蛋白（Hb）等各项营养指标，记录两组的低蛋白血症发生率（血清白蛋白约35 g/L）与感染发生率、神经功能缺损程度（NIHSS评分）与日常生活能力（Barthel指数）。结果观察组治疗后的AMC、Alb、PA、TLC与Hb水平显著高于治疗前及对照组治疗后，差异有统计学意义（P<0.05）。观察组的感染发生率与低蛋白血症发生率显著低于对照组，差异有统计学意义（P<0.05）。观察组治疗后的NIHSS评分显著低于对照组治疗后，差异有统计学意义（P<0.05）。观察组治疗后的Barthel指数显著高于对照组治疗后，差异有统计学意义（P<0.05）结论早期给予急性脑卒中患者肠内营养支持，可有效改善患者的营养状况，提高机体免疫力，促进神经功能恢复，降低感染发生率，改善患者的近期预后。