早期肠内营养对急性脑出血患者营养指标及预后的影响

Effect of early enteral nutrition on nutritional indicators and prognosis in patients with acute cerebral hemorrhage

目的探讨早期肠内营养(EEN)对急性脑出血患者的营养指标及其预后的影响。方法将92例急性脑出血患者随机分为治疗组和对照组各46例。对照组采用家属喂养+常规补液支持治疗,治疗组患者于入院后48 h内采用能全力经鼻胃管滴入行EEN治疗,连续3周。比较2组营养指标、并发症及预后情况。结果治疗后,治疗组的血清白蛋白(ALB)、前白蛋白(PA)及血红蛋白(Hb)水平较治疗前下降不明显,但对照组ALB、PA及Hb水平较治疗前显著下降(P均<0.05);与对照组比较,治疗组呼吸道感染、泌尿道感染及上消化道出血的发生率、病死率明显降低,患者意识状态明显改善(P均<0.05);治疗后,2组Fugl-Meyer评分、Barthel ADL评分均明显改善(P均<0.05),而治疗组的改善程度显著优于对照组(P<0.05)。结论急性脑出血患者给予EEN治疗,可改善患者的营养状况与免疫功能,减少各种并发症的发生,改善近期预后。

Objective It is to explore the effect of early enteral nutrition （EEN） on nutritional indicators and prognosis in patients with acute cerebral hemorrhage. Methods 92 patients with acute cerebral hemorrhage were randomly divided into two groups, including 46 cases of treatment group, 46 cases of control group. The control group was treated with family feeding and conventional rehydration therapy, and the treatment group was treated with EEN supplemented with nutrison fibre by nosetube feeding within 48 h admitted in our hospital. All the patients were treated for 3 weeks. The nutritional indicators, complications and prognosis were compared. Results Compared with those before treatment, there were no significant decrease on the level of ALB, PA and HB in treatment group, while those indicators in control group were significantly decreased （ all P 〈 0.05）. Compared with control group, the infection rate of respiratory tract, urinary tract, upper gastrointeatinal tract hemorrhage, mortality rate were significantly decreased, and conscious state was remarkably improved （ all P 〈 0.05 ）. After treatment, the scores of Fugl-Meyer and Barthel ADL were all improved, while those in treatment group were improved more remarkably （P 〈 0.05 ）. Conclusion EEN treatment for acute cerebral hemorrhage can improve nutrition status and immune function, reduce various kinds of complications, so as to improve patients＇ prognosis.