双歧三联活菌胶囊联合早期肠内营养对重症脑卒中患者营养状况及并发症的影响

摘要

目的：探讨双歧三联活菌胶囊联合早期肠内营养对重症脑卒中患者营养状况及并发症的影响。方法选取90例住院治疗的重症脑卒中患者，随机分为观察组45例和对照组45例。两组患者均予以降颅内压、保护脑细胞、预防感染、保护胃黏膜和维持水电解质酸碱平衡等基础治疗。对照组患者予以早期留置胃管鼻饲行肠内营养支持治疗，肠内营养液恒速（100ml／h）灌注，开始为500ml· d－1，后逐渐加量至1000～2000ml· d－1。观察组患者在对照组基础上加用双歧三联活菌胶囊研磨水化后自胃管注入，1260mg· d－1×14d。观察两组患者的治疗前后营养状况及格拉斯哥昏迷量表（ GCS）评分变化情况，并比较并发症的发生率。结果治疗14d后，两组患者血红蛋白（Hb）、总蛋白（TP）和白蛋白（ALB）水平均较前明显下降（P＜0．05、P＜0．01），且观察组下降幅度明显低于对照组（P＜0．05）；两组患者GCS 评分较前明显上升（ P＜0．05、P＜0．01），且观察组上升幅度明显高于对照组（ P＜0．05）；同时治疗14d期间，观察组中并发症发生率明显低于对照组（χ2＝3．85，P＜0．05）。结论双歧三联活菌胶囊联合早期肠内营养治疗重症脑卒中疗效较确切，可明显提高患者GCS评分，改善其营养状态，减少或预防并发症发生，改善其预后。%Objective To discuss influence of bifid tripleviable capsules combined with early enteral nutritiononnutritureandcomplicationofpatientswithseverestroke.Methods 90casesofpatientswithsevere stroke, who were given medical treatment in the hospital, were selected and divided into observation group and control group, with 45 cases of patients in either group.The patients in two groups were given basic medical treatment, such like lowering intracranial pressure, protecting brain cells, preventing infection, protecting stomach, maintaining water electrolyte and acid-base balance and etc.The patients in control group were given early gastric tube indwelling nasogastric enteral nutrition support treatment and peptison enteric nutrition fluid by constant speed infusion (100ml/h) from 500ml· d-1 to 1000-2000ml· d-1 gradually.The patients in observation group were additionally given 420mg Bifid Triple Viable Capsules, which were ground, hydrated and injected by stomach tube, three times a day, for 14 days.The changes of nutrition state and Glasgow Coma Scale ( GCS) of patients in two groups before and after medical treatment were observed, and the occurrence rates of complication were compared as well.Results After 14 days medical treatment, hemoglobin ( Hb ) , total protein ( TP ) and albumin ( ALB ) levels obviously declined than before ( P<0.05 or P<0.01) , and the declining rate of patients in observation group was much lower than that in control group (P<0.05).The GCS of patients in two groups obviously rose than before (P<0.05 or P<0.01) , and the rising rate of patients in observation group was much higher than that in control group ( P<0.05) . Meanwhile, during the 14 days medical treatment, occurrence rate of complication of patients in observation group was much lower than that in control group (χ2 =3.85, P<0.05 ) .Conclusion Bifid Triple Viable Capsules combined with early enteral nutrition has favorable curative effect on severe stroke, which can obviously raise GCS of patients, improve nutrition state, reduce and prevent the occurrence of complication and improve the prognosis.