两种肠内营养途径对脑卒中吞咽障碍患者肠内营养的耐受性和疗效

Two kinds of enteral nutrition in patients with dysphagia after stroke tolerance and efficacy of enteral nutrition

〔目的〕观察应用鼻胃管和鼻空肠管对脑卒中患者进行肠内营养(entera nutrition,EN)的耐受性和疗效。〔方法〕104例脑卒中患者按照EN途径不同随机分为2组:留置鼻胃管组(A组,n=52)和留置鼻空肠管组(B组,n=52),在常规护理和治疗外进行EN治疗。观察2组患者对EN的耐受情况、EN前和EN后14 d血清前清蛋白和淋巴细胞计数变化。〔结果〕A组患者对EN的耐受性比B组差(23.08%vs 7.69%,P=0.030),住院后14 d,A组患者血清前清蛋白(0.22±0.06 vs 0.37±0.16,P=0.039)和淋巴细胞计数(1.26±0.53 vs 3.13±1.57,P=0.006)低于B组。〔结论〕脑卒中患者留置鼻空肠管进行EN治疗的耐受性和疗效优于传统的鼻胃管。

〔Objective〕Observation of the application of nasogastric or nasojejunal feeding tube in patients with cerebral stroke of enteral nutrition（ Entera nutrition, EN） of tolerance of and effect. 〔Methods〕104 cases of stroke patients were randomly divided into 2 groups according to the EN pathway： Indwelling nasogastric tube group（ group A, n = 52） and indwelling nasojejunal tube group（ group B, n = 52）, EN treatment was performed in routine care and treatment. Two groups were observed in patients with the tolerance of EN, EN and EN after 14 days of serum prealbumin and lymphocyte count changes. 〔Results〕The tolerance to EN in patients with A was worse than that of B group（ 23. 08% vs 7. 69%, P = 0. 030）, 14 days after hospitalization, A group of serum PAB protein（ 0. 22 ＋ 0. 06 vs 37 ＋ 0. 16, P = 0. 039） and lymphocyte count（ ＋ 1. 26 0. 53 vs 3. 13 ＋ 1. 57, P = 0. 006）was lower than that of B group. 〔Conclusion〕Tolerability and efficacy of nasogastric tube is better than the traditional stroke patients with indwelling nasojejunal tube for the treatment of EN.