一例脑干梗死植物生存状态十年患者营养支持状况分析

Nasal feeding case of a brain stem infarction patient in a vegetative state for ten years

目的 通过对一例植物生存状态10年患者鼻饲食疗配方的分析研究,并结合对患者应用效果的临床观察,探讨如何合理选择、搭配和制作鼻饲膳食,做好植物生存状态患者的营养支持,保持和改善患者的营养状况.方法 在护士及营养师的指导下,采用患者家属自制鼻饲匀浆膳食进行胃肠内营养支持,匀浆膳食由谷类、面食、禽类、鱼虾类、甲壳类、蔬菜类、牛奶、水果及油、盐等组成,由捣碎机研磨成糊状后为患者分次输入.依据患者病情,每日调配1680 kcal左右热量的膳食,其中蛋白质占总热量的15%-20%,脂肪占20%-25%,碳水化合物占55%-60%.结果 患者入院后应用鼻饲匀浆膳食已满10年,在营养丰富、高质量的匀浆膳食的支持下,患者病情稳定,身体状况良好,心、肺、肝、肾等脏器功能正常,血脂、血细胞等数量也在正常范围内,体质量无明显下降,两便正常.结论 自制匀浆膳食不仅经济、安全、方便,而且易于消化吸收,如能再积极配合有效的临床治疗对维持患者机体健康、延长患者生命起到至关重要的作用.

Objective To investigate a nasal feeding case of a brain stem infarction patient in a vegetative state for ten years and its application effects in clinical practice, in order to explore better nutritional support of nasal feeding with reasonable food selection and production, and to maintain and improve patients′nutritional status. Methods With the guidance of nurses and nutritionists, nasal feeding homogenate diet were used to support gastrointestinal nutrition and were made by family members of the patient, which contained cereals, cooked wheaten food, poultry, fish, shellfish, vegetables, milk, fruit, oil and salt. The diet were ground into paste by pounding machine and infused to the patient several times. According to the patient′s condition, the diet were 1680 kcal/day and contained 15% 20% proteins, 20% 25% fat, and 55% 60%carbohydrate. Results During the ten years of high nutrition and quality nasal feeding homogenate diet, the patient was in a very stable condition, with normal function of heart, lung, liver, kidney and other viscera. The blood lipid and blood cells were in normal range with normal urination and defecation, and had no obvious weight loss. Conclusions Homemade homogenate diet is not only very cost-efficient, safe and convenient, but also very easy to digest. It will play a significant role in maintaining patients′physical health and prolonging life if combined with effective clinical treatment.