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不同营养制剂对老年急性脑卒中伴吞咽障碍患者预后的影响

The Recovery Effect of Different Enteral Nutrition Support in Older Patients Diagnosed of Acute Cerebral Stroke With Dysphagia
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摘要 目的探讨不同肠内营养制剂对老年急性脑卒中伴吞咽障碍患者预后的影响。方法收集70例老年急性脑卒中伴吞咽障碍患者,随机分为两组,试验组35例,对照组35例,在常规脑卒中治疗的基础上,试验组给予肠内高营养制剂,对照组给予自制匀浆流食。观察两组患者入院时及治疗后第10天、第21天的营养状态、免疫功能、美国国立卫生研究院神经功能缺损评分(NIHSS评分)及并发症发生率。结果(1)治疗后第21天试验组血清白蛋白(ALB)、血清前白蛋白(PA)、血红蛋白(HGB)均出现回升,改善程度优于对照组(P<0.05),试验组总淋巴细胞计数(TLC)、Ig A、Ig G、Ig M均较对照组升高(P<0.05)。(2)治疗后第21天试验组NIHSS评分降低程度较对照组更明显(P<0.05)。(3)试验组并发症发生率为45.7%(16/35)低于对照组并发症发生率71.4%(25/35)(P<0.05)。结论肠内高营养制剂可有效改善老年急性脑卒中伴吞咽障碍患者的营养状态及预后。 Objective To explore the effectiveness of different enteral nutrition support on prognosis in the older patients diagnosed of acute cerebral stroke with dysphagia. Methods On the basis of the conven^ial treatment of cerebral stroke, seventy older phtients diagnosed of acute cerebral stroke with dysphagia were randomly divided into two groups, the treatment group (n=35) was given enteral nutrition, and the control group (n=35) was given self-made liquid diet. The levels of nutritional indicators, immune function, the score of national institute of health stroke scale (NIHSS) and the incidence of complications were evaluated before and at the 10th day, the 21st day after the therapy. Results (1)Compared with the control group, the level of serum albumin(ALB), prealbumin(PA) and hemoglobin(HGB) significantly increased in the treatment group (P 〈 0.05), and patients in the treatment group had higher level of TLC, IgA, IgG, IgM (P 〈 0.05) at the 21st day.(2)The score of NIHSS at the 21st day was distinctly more improved in the treatment group than those in the control group (P 〈 0.05). (3)The incidence of complications in the treatment group (45.7%, 16/35) was lower than the control group (71.4%, 25/35) at the 21st day (P 〈 0.05). Conclusion Enteral nutrition support can significantly improve nutritional status and prognosis in the older patients diagnosed of acute cerebral stroke with dysphagia.
作者 黄上萌 兰文斌 易志刚 郭文安 吴娟 HUANG Shangmeng LAN Wenbin YI Zhigang GUO Wen'an WU Juan(Cadres Health Care Ward, The First Affiliated Hospital of Xiamen University, Xiamen Fujian 361003, China Department of Respiratory Diseases)
出处 《中国卫生标准管理》 2017年第15期1-3,共3页 China Health Standard Management
关键词 肠内营养 脑卒中 预后 enteral nutrition support cerebral stroke prognosis
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