急性脑卒中合并吞咽困难患者肠内营养支持治疗的临床疗效

Clinical efficacy of enteral nutritional support in the treatment of patients with dysphagia and acute stroke

目的探讨急性脑卒中合并吞咽困难患者肠内营养支持治疗的临床疗效。方法选取本院2009年11月～2011年12月收治的急性脑卒中合并吞咽困难患者104例,随机分为两组,采用匀浆膳营养支持治疗患者52例为对照组,采用序贯性营养支持治疗患者52例为观察组,治疗疗程均为3周,并给予护理干预,比较两组患者治疗前后的营养指标和并发症情况。结果治疗后,观察组与对照组血白蛋白、血红蛋白、血前白蛋白均明显升高,观察组血白蛋白、血红蛋白、血前白蛋白均明显高于对照组,差异均有统计学意义(P<0.05)。观察组与对照组上皮肌围、皮褶厚度均略有增大,观察组上皮肌围、皮褶厚度均略大于对照组,差异均无统计学意义(P>0.05)。观察组并发症发生率(19.2%)明显低于对照组(42.3%),差异有统计学意义(P<0.05)。结论急性脑卒中合并吞咽困难患者在早期采用肠内营养支持治疗可以明显改善机体的临床症状和营养状况,有效的护理干预可以降低并发症的发生率,更有助于患者身体的早日康复,值得临床推广使用。

Objective To investigate the clinical efficacy of enteral nutritional support in the treatment of patients with dysphagia and acute stroke. Methods 104 patients with dysphagia and acute stroke were selected in the hospital from November 2009 to December 2011,who were randomly divided into two groups. 52 patients were given homogenate nutri- tional support treatment as the control group, 52 patients were given sequential nutritional support treatment as the obser- vation group. The course of treatment was 3 weeks. All patients were given nursing intervention. Nutrition index and com- plications were compared between two groups before and after treatment. Results After treatment, serum albumin, hemoglobin, serum prealbumin in the observation group and the control group elevated significantly, serum albumin, hemoglobin, serum prealbumin in the observation group were significantly higher than those in the control group, the dif- ference was statistically significant （P 〈 0.05）. Epithelial muscle circumference, skin fold thickness in the observation group and the control group increased slightly, epithelial muscle circumference, skin fold thickness in the observation groups were slightly larger than those in the control group, there were no significant differences between them （P 〉 0.05）. Complication rate in the observation group （19.2%） was significantly lower than that in the control group （42.3%）, The dif- ference was statistically significant （P 〈 0.05）. Conclusion Early enteral nutrition support therapy for patients with dyspha- gia and acute stroke can significantly improve the clinical symptoms and nutritional status. Effective nursing intervention can reduce the incidence of complications, which is more helpful for patients with physical rehabilitation. It is worthy of clinical use.