脑卒中患者吞咽障碍评估与营养支持的护理配合

Dysphagia assessment and care with nutritional support in patients with stroke

目的探讨脑卒中患者吞咽障碍评估和不同方式营养支持护理对患者的影响。方法对212例急性脑卒中患者进行吞咽障碍评估,将符合吞咽障碍标准的87患者随机分成观察组和对照组,观察组44例进行肠内与肠外贯序营养支持,对照组43例给予完全肠外营养支持,比较2组患者治疗后的影响指标与并发症发生情况。结果营养支持3周后,观察组血清总蛋白(67.8±2.1)g/L、血清白蛋白(37.6±1.8)g/L、血红蛋白(129.8±13.8)g/L,计数均高于对照组(P<0.05);观察组并发症发生率(27.27%)和病死率(2.27%)均明显低于对照组的48.48%、13.95%(P<0.05)。结论肠内与肠外贯序营养支持对脑卒中伴有吞咽障碍的患者护理效果显著,能够明显改善患者的营养状况,降低并发症的发生率,有利于患者疾病的康复。

Objective To investigate the effect of dysphagia assessment and nutritional support different ways of care for stroke patients. Methods Totally 212 cases of acute stroke patients with dysphagia assessment criteria complicated with dysphagia, 87 patients were randomly divided into observation group and control group, 44 cases of the observation group were given sequential enteral and parenteral nutrition support, and 43 patients in the control group were given total parenteral nutritional support, the occurrence of impact indicators with complications in the two groups were compared. Results After 3 weeks of nutritional support in observation group, serum total protein （67.8±2.1） g/L, serum albumin （37.6±1.8） g/L, hemoglobin （129.8 ± 13.8） g/L were higher than those of control group （P 〈0.05）; complication rate （27.27%） and mortality （2.27%） in observation group were significantly lower than those in control group（48.48%, 13.95%, P〈0. 05）. Conclusion The care effect of sequential enteral and parenteral nutrition support for stroke patients with dysphagia is significant, and can significantly improve the patient＇s nutritional status and reduce the incidence of complications, which is conducive to the rehabilitation of patients with the disease.