早期肠内营养支持治疗对脑干梗死病人营养指标和预后的影响

Effect of early enteral nutrition on the nutritional indicators and prognosis in patients with acute brainstem infarction

目的:研究早期肠内营养(EEN)支持治疗对急性脑干梗死病人营养指标和预后的影响。方法:将64例伴有吞咽障碍的脑干梗死病人随机分为治疗组(n=34)和对照组(n=30)。入院后24～72 h内,治疗组病人给予鼻饲肠内营养(瑞先)支持,对照组病人给予普通鼻饲饮食。比较两组病人治疗前、治疗第14天营养指标的变化、神经功能评分(NIHSS评分)和并发症的发生率。结果:治疗组病人治疗14 d后,血清清蛋白(ALB)和前清蛋白(PA)无明显降低,与治疗前比无显著性差异(P≥0.05);而对照组治疗14 d后,ALB和PA均较入院前降低(P<0.05)。治疗14 d后,治疗组ALB和PA均高于对照组,两组间比较,差异有显著性统计学意义(P<0.05)。治疗组病人上消化道出血和肺部感染的发生率均显著低于对照组(P<0.05),NIHSS评分显著优于对照组(P<0.05)。结论:早期合理EN支持,可减轻重症脑干梗死病人的营养状况恶化程度,减少并发症,改善预后。

Objective： To investigate the effects of early enteral nutrition （EEN） on nutritional indicators and prognosis in patients with acute brainstem infarction. Methods ： 64 cases of acute brain-stem infarction accompanied with dysphagia were randomly divided into two groups, EEN treatment group treated with nasogastric enteral nutrition support with enteral nutritional emulsion （TPF） （34 cases） and the control group treated with general nasal feeding diet. （30 cases）. The nutritional indicators, neuro- logical scores （ NIH Stroke Scale, NIHSS） and the incidence of complications were observed. Results ： The nutrition indicators such as serum albumin （ALB） and prealbumin （PA） decreased in the control group （P 〈 0.05 ）, while the treatment group did not. On day 14, the ALB and PA levels of the EEN group were higher than that of the control group （P 〈 0.05 ）. The incidence rates of upper gastrointestinal bleeding and pulmonary infection in treatment group were significantly lower than those of the control group （P 〈 0.05 ）. NIHSS scores in treatment group was significantly better than that of the control group （P 〈 0.05 ）. Conclusion： Reasonable EEN could reduce the deterioration of the nutritional status of patients with brainstem infarction and the associated complications.