重症脑卒中患者肠内营养制剂干预效果分析

Analysis on the Intervetion Effect of Enteral Nutrition on Patients with Severe Stroke

目的分析不同的肠内营养制剂对重症脑卒中患者的干预效果。方法将92例重症脑卒中患者根据自愿原则将患者随机分为3组。应用自制匀浆膳食作为对照,干预组-1采用临床上常用的整蛋白肠内营养制剂,干预组-2采用短肽制剂和整蛋白营养制剂的序贯性应用对重症脑卒中患者进行营养干预。观察干预前后患者的蛋白指标以及感染并发症的发生率。结果干预前,3组患者的基本状态和各项指标均无显著性差异。干预后,两个干预组的蛋白水平均有改善,干预组-2优于干预组-1(P<0.05);干预组-2患者的感染并发症的发生率明显低于干预组-1和对照组(P<0.05)。结论对重症脑卒中患者,短肽制剂和整蛋白营养制剂的序贯性应用能够改善患者的营养状态,减少感染并发症,改善预后。

Objective To analysis the effects of intervention with different enteral nutritions on the severe stroke patients.Methods In a randomized controlled trial design,92 patients in the department of NCU in the 1St hospital of clinical medicine of Jilin University were selected.There are three groups in the trial according voluntary principles.The control group received feeding supervised by homogenized diet,the intervention group1 received the sole application of the entire protein-based enteral nutrition preparations,the intervention group2 received the application of the generic peptide-based enteral nutrition preparation and then gradually the dietary-fiber type entire protein-based enteral nutrition preparations.To observed the nutrition and clinical status on the day of before and after intervetion,and infective complications of the three groups were also compared.Results Before intervention all the general states of health and nutrtion and clinical status of three groups had no significantly differences（P〉0.05）.After intervetion,the levels of states of intervention groups had significantly differences than before（P〈0.05）and the level of protein in intervetion-2 was higher than intervention-1（P〈0.05）.The incidence of infective complications in intervention-2 groups was significantly lower than control group（χ2=6.399,P=0.011）.Conclusion The method of the application of the generic peptide-based enteral nutrition preparation and then gradually the dietary-fiber type entire protein-based enteral nutrition preparations can significantly improve nutritional status,decrease the incidence of infective complications.