肠内营养对脑梗死致急性假性球麻痹疗效的研究

Study on the enteral nutrition to the effect of cerebral infarction induced acute pseu dobulbar palsy

目的 探讨肠内营养对脑梗死致急性假性球麻痹 (APBP)及其并发症的疗效。方法 将 6 0例脑梗死致 APBP患者随机分成营养组和对照组 ,观察二组患者治疗后吞咽困难改善率、肺部感染发生率、神经功能改善率和 T淋巴亚群的变化。结果 经 10天治疗后 ,营养组和对照组吞咽困难改善率、肺部感染发生率、神经功能改善率分别为 83.3%和 5 6 .7% (P <0 .0 5 ) ;13.3%和 40 % (P <0 .0 5 ) ;76 .7%和 46 .7% (P<0 .0 5 )。另外 ,肠内营养组治疗后抑制性免疫指标 CD8较治疗前和对照组治疗后明显下降 (P<0 .0 5 ) ,而增强性免疫指标 CD3、CD4和 CD4/CD8较治疗前和对照组治疗后显著提高 (P<0 .0 5 )。结论 肠内营养能提供肌体所需要的蛋白、碳水化合物和脂肪等成分。对 APBP患者存在的吞咽困难、营养不良不仅能提高人体细胞免疫功能 ,而且能减少并发症、提高疗效、从而改善预后。

Objective To investigate the effect on enteral nutrition to cerebral infartion (CI) induced acute pseudobulbar palsy (APBP) and its complication. Methods 60 patients with CI induced APBP were randomly divived into nutrition and control groups. The improvement rate of dysphagia and nervous function, the incidence rate of pulmonary infection and variation of T lymphocytes subgroup after treatment in two groups were observed.Results The improvement rate of dysphagia and nervous function, the incidence rates of pulmonary infection in nutrition and control groups were 83.3% and 56.7%(P<0.05),76 7% and 46.7%(P<0.05),13.3%and 40.0%(P<0.05) respectively.Meanwhile,the inhibitory immune marker CD 8 was lower after treatment in the nutrition group than before treatment and after treatment in the controls (P< 0.05 ), and the increased immune maker CD 3, CD 4and CD 4/CD 8 after treatment was significantly higher than before treatment and after treatment in the controls(P<0.05).Conclusion Enteral nutrition could provide protein,carbohydrate and fat,they not only increased cell immune function but also decreased complications,and improved prognosis to APBP patients with dysphagia and dystrophy.