早期序贯式肠内营养支持在老年吞咽困难患者中的应用效果研究

Research on the effect of early enteral nutritional support in elderly patients with dysphagia

目的探讨早期序贯式肠内营养支持在老年吞咽困难患者中的应用效果。方法将105例吞咽困难的患者随机分为研究组(n=55例)和对照组(n=50例),研究组由营养科介入,于入院后48 h内留置鼻胃管行序贯式肠内营养支持;对照组由家属自行鼻饲喂养。营养支持14 d后,观察两组患者的营养指标(血清白蛋白、血红蛋白、肱三头肌皮褶厚度、甘油三酯)、细胞免疫指标(CD3+、CD4+、CD8+)和并发症发生情况。结果营养支持14 d后,研究组患者血清白蛋白、血红蛋白、甘油三酯明显高于对照组(P<0.05);CD3+、CD4+、CD4+/CD8+比值均有明显增加,与对照组比较差异有统计学意义(P<0.05);研究组患者总感染率及胃肠道并发症的发生率均低于对照组(P<0.05)。结论合理的肠内营养支持能改善老年吞咽困难患者的营养状况和免疫功能,降低感染发生,促进病人康复。

Objective To explore the effect of early standardized enteral nutrition support on elderly dys- phagia patients. Methods 105 patients with dysphagia were randomly divided into study group （n ：55） and control group （n =50）. The study group was treated with standardized enteral nutritional support, while the control group was treated with homogenate suspension of nutrients mixture. The clinical parame- ters related to nutrient （ALB, Hb, TSF, TG） and immune situation （CD3＋, CD4＋, CD8＋） and the adverse reactions were recorded and compared before and after 14 days between two groups. Results After 14 days Support, the levels of serumalbumin,hemoglobin of patients in study group was significantly high- er than control group （P 〈 0.05） ; CD4＋ , CD4/CD8＋ ratio improved significantly （P 〈 0.05） ; the incidence rate of infection and gastrointestinal complications in study group was significantly lower than the control group （P 〈0.05）. Conclusion Reasonable entera, nutrition can significantly improve the nutritional status and immune function in elderly patients with dysphagia, reduce infection and promote patients＇ recovery.