探究早期肠内营养联合药膳预防脑卒中患者合并应激性溃疡出血的临床疗效观察及安全性评价

Early Enteral Nutrition in Combination with Medicinal Food to Prevent Cerebral Apoplexy Patients with Clinical Effect of Treatment of Stress Ulcer Bleeding and Safety Evaluation

目的：探究与分析早期肠胃营养联合药膳预防脑卒中患者合并应激性溃疡出血的临床疗效观察及安全性评价。方法：选取我院自2014年2月~2015年2月神经外科收治的60例脑卒中患者患者作为研究对象,采取随机数字表法分为常规治疗组与联合治疗组,每组各30例。其中常规治疗组早期运用一般肠内营养预防脑卒中后应激性溃疡出血,联合治疗组在常规治疗组的基础上联合中华药膳食疗,对比2组患者系统治疗1 w后的胃酸强度、胃液潜血率、大便潜血率、应激性溃疡出血的发生率以及患者的死亡率和好转率,并对2组患者用药后的肝功能异常、失眠、头痛等不良反应作出比较,综合分析2组患者的临床疗效。结果：系统治疗1 w后,常规治疗组24 h平均胃内p H、夜间平均胃内p H明显低于联合治疗组,差异显著（t=3.98,P〈0.05;t=4.58,P〈0.05）;常规治疗组24 h的p H〈4.0发生率以及夜间p H〈4.0的发生率明显高于联合治疗组,差异显著（t=4.21,P〈0.05;t=4.28,P〈0.05）;常规治疗组胃液潜血率、大便潜血率、应激性溃疡发生率、病死率明显高于联合治疗组,差异显著（χ2=4.36,P〈0.05;χ2=4.80,P〈0.05;χ2=5.49,P〈0.05;χ2=4.29,P〈0.05）;联合治疗组不良反应发生率较常规治疗组相比显著降低,组间差异显著（χ2=15.86、5.45、4.51,P〈0.05）。结论：早期胃肠营养联合中华药膳食疗可有效控制胃酸强度,协同预防脑卒中患者合并应激性溃疡的发生,提高患者生活质量,安全可靠,值得广泛推广与应用。

Objective： To explore and analyze the early gastrointestinal nutrition joint medicinal food to prevent stroke patients with the clinical effect of the treatment of stress ulcer bleeding and safety evaluation. Methods： Select our hospital from February 2014 to February 2014 of 60 patients with cerebral apoplexy patients admitted in neurosurgery as the research object,take a random number table method divided into conventional treatment group and combination group,30 cases in each group. The conventional treatment group early use of enteral nutrition after stroke prevention commonly stress ulcer bleeding,combined treatment group in the conventional treatment group on the basis of the Chinese medicinal diet,compared two groups of system 1 week after treatment in patients with gastric acid strength,occult blood gastric juice rate,rate of defecate occult blood,the incidence and mortality in patients with stress ulcer bleeding and the recovery,and the two groups of patients with medication after the adverse reactions such as headache,insomnia,abnormal liver function to make a comparison and comprehensive analysis of the clinical efficacy of two groups of patients. Results：The system a week after the treatment,routine treatment group within 24 h average gastric p H,average night gastric p H was lower than that in combination group,significant difference（ t = 3. 98,P〈0. 05,t = 0. 05,P〈0. 05）; Conventional treatment group of24 h p H 4. 0 incidence and night 4. 0 significantly higher incidence of combined treatment group,significant difference（ t = 4. 21,P〈0. 05,t = 0. 05,P〈0. 05）; Conventional treatment group rate,rate of defecate occult blood of gastric juice occult blood,stress ulcer incidence and case fatality rate significantly higher than the combination group,significant difference（ χ2= 4. 36,P〈0. 05;χ2= 4. 80,P〈0. 05; χ2= 5. 49,P〈0. 05; χ2= 4. 29,P〈0. 05）; Combined treatment group adverse reactions compared to the conventional treatment group decreased significantly,the incidence of significant difference between groups（ χ2 = 15. 86,5. 45,4. 51,P〈0. 05）. Conclusion： Early gastrointestinal nutrition joint strength of the Chinese medicinal food diet can effectively control the hydrochloric acid in gastric juice,coordinated prevent the happening of the consolidation stress ulcer in patients with cerebral apoplexy,improve patient quality of life,safe and reliable,is worth popularization and application widely.