早期肠内营养对重症脑血管病患者营养状况、免疫功能及预后的影响分析

Effect of early enteral nutrition on nutritional status,immune function,and prognosis in patients with severe cerebrovascular disease

目的探讨和分析早期肠内营养支持对重症脑血管病(SCVD)患者营养状况、免疫功能及预后的影响。方法选取我院的56例重症脑血管病患者作为研究资料,依据护理方式不同,双盲法随机分为对照组(肠外营养支持)和研究组(早期肠内营养支持),各28例。分别于入院当天、营养支持后10 d对两组患者的营养状况、免疫功能以及预后进行比较。结果营养支持10 d后,研究组血清总蛋白(TP)、三酰甘油(TG)、谷丙转氨酶(ALT)、血糖(GLU)4项指标显著优于对照组,差异具有统计学意义(P<0.05)。研究组与对照组相比,Ig G、Ig A、CD4/CD8水平显著升高,TLC水平显著下降,差异均具有统计学意义(P<0.05)。研究组日常生活能力(ADL)评分和Fugl-Meyer运动功能(FMA)评分高于对照组,美国国立卫生研究院卒中量表(NIHSS)指数低于对照组,差异均具有统计学意义(P<0.05)。结论对于重症脑血管病患者,早期的肠内营养支持能给予患者必须的营养支持,改善机体调节紊乱,增强免疫能力,改善患者预后及提升患者生存质量,临床值得推广运用。

Objective To investigate and analyze the effect of early enteral nutrition support on nutritional status,immune function,and prognosis in patients with severe cerebrovascular disease（ SCVD）. Methods Fifty-six patients with SCVD who were treated in our hospital were selected as research subjects and were divided into control group（ parenteral nutrition support） and research group（ early enteral nutrition support） according to the nursing methods,with 28 patients in each group. The nutritional status,immune function,and prognosis of the two groups were compared on the day of admission and after nutritional support for 10 days. Results After the nutritional support for 10 days,compared with the control group,the research group had significantly higher serum levels of total protein,triglyceride,alanine aminotransferase,and blood glucose,as well as significantly higher levels of Ig G,Ig A,and CD4 / CD8,and a significantly lower total lymphocyte count（ P〈0.05）. Compared with the control group,the research group had significantly higher Activities of Daily Living score and Fugl-Meyer motor function score and a significantly lower National Institutes of Health Stroke Scale score（ P〈0. 05）. Conclusions In patients with SCVD,early enteral nutrition support can provide necessary nutritional support,improve the health status,regulate disorders,enhance immunity,and improve patient outcome and quality of life,and,therefore,it is worthy of clinical promotion and application.