早期鼻饲对老年脑卒中患者康复的影响

Effect of early nasogastric feeding on rehabilitation of senile patients with post-stroke

目的探讨早期鼻饲营养支持对脑卒中患者营养状况改善、感染性并发症的发生及神经功能康复的影响。方法收集伴有进食障碍脑卒中住院病例44例,随机分为2组：早期鼻饲组及对照组。均给予鼻肠内营养支持治疗,其余治疗措施相同,时间为1个月。监测2组患者营养状况（指标包括血白蛋白,血红蛋白及血淋巴细胞总数）和神经功能缺损程度（NFS）以及进食障碍的持续时间,并观察感染性并发症的发生（消化道出血、肺部感染及死亡）情况。结果早期鼻饲营养支持组患者的营养状况良好,血白蛋白,血红蛋白及血淋巴细胞总数均显著高于对照组（P〈0.05）;2组间进食障碍的持续时间无显著性差异（P〉0.05）,但NFS指标有显著性差异（P〈0.05）;此外,早期鼻饲组感染性并发症的发生率较对照组低（P〈0.05）。结论早期鼻饲营养支持有利于改善脑卒中后的营养状况,减少感染性并发症的发生,有利于神经功能的恢复。

Objective To explore the effect of nasogastric feeding as early nutritional support on the patient with post-stroke.Methods 44 stroke patients with dysphagia were collected.The patients were divided into two groups： study group（given nasogastric feeding 1～3 days after stroke）,control group（given nasogastric feeding 7～10 days after stroke）.The patients in both groups received enteral nutrition and routine treatment for one month.Their nutritional state（including serum albumin,hemoglobin and the number of lymphocyte） and NFS and the time of dysphagia state as well as the incidence of infectious complication were evaluated by end of one month.Results The patients in study group were in good nutrition status and their albumin and hemoglobin and lymphocyte were significantly higher than that of control group（P〈0.05）.There was no significantly difference in the time of dysphagia between two groups（P〉0.05）.NFS of study group was better than that of control group（P〈0.05）.The incidence of infectious complication of study group was less than that of control group（P〈0.05）.Conclusions Early nasogastric feeding is favorable for the improvement of the patient＇s post-stroke nutritional state and can reduce the incidence of infectious complication as well as promote the rehabilitation of neurofunction.