老年脑血管意外患者肠内营养支持疗效观察

Clinical effect observation of enteral nutritional support in elderly patients with cerebrovascular accident

目的观察老年脑血管意外患者肠内营养支持的疗效。方法 29例患者的营养治疗方案分3个阶段。第1阶段给予短肽型肠内营养剂(百普素)要素营养制剂,第2阶段给予要素营养制剂加低浓度匀浆膳,第3阶段过渡至高热量匀浆膳或口服自然饮食。观察营养支持前后临床表现、人体测量指标、实验室检查等情况。结果在14d左右达第3阶段21例,在第1、2阶段因伴有严重的肺部感染并继发多器官功能衰竭死亡5例,因胃肠应激性溃疡出血改为肠外营养3例;营养支持前后三头肌皮褶厚度(TSF)、上臂围(MAC)、上臂肌围(MAMC)均为正常值的80%～90%,但营养支持前后各指标比较差异均无统计学意义(P>0.05);营养支持前后各项实验室检查指标均在正常范围,且营养支持前后各指标比较差异均无统计学意义(P>0.05)。结论较为完善的营养支持设计可使老年脑血管意外患者得到合理的、有效的营养支持,减少并发症的发生。

Objective To observe the effect of enteral nutrition support in elderly patients with cerebrovascular accident.Methods Analyzed the nutrition support schemes of 29 elderly cases with cerebrovascular accident retrospectively.The first phase gave Pepti-2000 Variant element diet;The second phase gave element diet and homogenized diet of low concentration;The third phase transited to high-calorie homogenized diet or oral natural diet.Observed the clinical manifestation,anthropometric parameter and laboratory examination before and after nutrition support.Results 21 cases had arrived the third phase in about two weeks.5 cases died of MOFS followed severe lung infection in the early two phases.3 cases changed to parenteral nutrition because of stress ulcer.TSF,MAC,MAMC were all 80%～90% of normal,but the differences of these indexes were of no statistical significance between before and after nutrition support（P〉0.05）.All laboratory examination indexes were normal,and the differences of these indexes were of no statistical significance between before and after nutrition support（P〉0.05）.Conclusion More perfectly nutrition support design can provide relative and effective nutrition support for elderly patients with cerebrovascular accident,and reduce the occurrence of complication.