神经危重症患者发生胃潴留相关危险因素及营养支持对预后的影响分析

Risk Factors and Nutritional Support in Patients with Severe Neurological Disorders and Their Effects on Prognosis

目的分析神经危重症患者发生胃潴留相关危险因素及营养支持对预后的影响。方法随机抽取该院2014年6月—2015年6月期间收治的83例神经危重症患者作为该次研究对象,根据胃腔残留量是否超过200 m L,分为胃潴留组(n=45例)和非胃潴留组(n=38例),胃潴留组患者采取肠内外营养支持,非胃潴留组采取全肠内营养支持,采取Logistic回归分析,分析胃潴留发生的危险因素,并比较两组营养支持前后血清白蛋白、前白蛋白、血红蛋白等指标变化。结果观察组患者的GCS评分为(6.54±1.02)分,对照组患者的GCS评分为(10.87±2.54)分,组间比较差异有统计学意义(P<0.05);经Logistic回归分析,GCS评分是引起胃潴留发生的危险因素(P<0.05);两组营养支持前后血清蛋白指标变化差异无统计学意义(P>0.05)。结论对发生胃潴留患者实施全肠内营养支持及肠内外营养支持的疗效相当,能改善其预后。

Objective To analyze the risk factors of gastric retention and the effect of nutritional support on the prognosis of patients with severe neurological diseases. Methods Randomly selected from our hospital in 2014 June to June 2015 were83 cases of nerve in critically ill patients as the research object, according to the stomach cavity residues is more than200 ml, for gastric retention group（45 cases） and non gastric retention group（38 cases）, gastric retention group patients take enteral and parenteral nutrition support, non gastric retention group take full enteral nutrition support, Logistic regression analysis was adopted to analyze the risk factors of gastric retention, and the changes of serum albumin, pre albumin and hemoglobin were compared between the two groups.Results Observation group of patients with GCS score（6.54±1.02）points,for the control group of patients with GCS score（10.87± 2.54）points, the difference between the two groups has statistical significance（P〈0.05）; Logistic regression analysis, Glasgow Coma Scale（GCS） is caused by the occurrence of gastric retention risk factors（P〈0.05）; Two groups of nutrition support before and after the change of serum protein markers and no significant difference（P〉0.05）. Conclusion The effect of total enteral nutrition support and enteral and parenteral nutrition support in patients with gastric retention is considerable, and it can improve the prognosis of patients with gastric retention.