不同早期营养支持对重度脑梗死患者营养状态和免疫状态的影响

Influence of different early nutritional supports on nutritional status and immune status of severe cerebral infarction patients

目的探讨不同早期营养支持对重度脑梗死患者营养状态、免疫状态的影响。方法选取莘县人民医院2016年1月—2017年1月收治的重度脑梗死患者164例,采用随机数字表法分为早期肠内营养(EEN)组(n=82)和早期肠外营养(EPN)组(n=82)。EPN组患者予以肠外营养支持,EEN组患者予以肠内营养支持。比较两组患者治疗前后营养状态[清蛋白(Alb)、血红蛋白(Hb)]、免疫状态[补体C3、淋巴细胞计数(LYM)],并观察患者并发症(肺部感染、胃肠道症状、电解质紊乱)发生情况。结果治疗前,两组患者Alb、Hb、补体C3、LYM水平比较,差异无统计学意义(P>0.05);治疗后,EEN组患者Alb、Hb、LYM高于EPN组,补体C3低于EPN组(P<0.05)。EEN组患者肺部感染、胃肠道症状、电解质紊乱发生率低于EPN组(P<0.05)。结论 EEN在重度脑梗死患者中的应用效果优于EPN,其可更有效地改善患者的营养状态及免疫状态,且安全性更高。

Objective To explore influence of different early nutritional supports on nutritional status and immune status of severe cerebral infarction patients.Methods A total of 164 cases of patients with severe cerebral infarction were selected from January 2016 to January 2017 in Shenxian People＇ s Hospital, which were divided into early enteral nutrition （ EEN ） group （ n=82 ） and early parenteral nutrition （ EPN ） group （n=82） according to random number table.EEN group was given early enteral nutrition, EPN group was given early parenteral nutrition.The nutritional status （ Alb, Hb ） , immune status （ complement C3, LYM ） before and after treatment were compared between the two groups, and the incidence of complications （pulmonary infection, gastrointestinal symptoms, electrolyte disturbances ） were observed.Results Before treatment, no significant differences of Alb, Hb, complement C3 or LYM was found between the two groups （ P〉0.05 ） ; after treatment, the EEN group of Alb, Hb, LYM were higher than EPN group, complement C3 was lower than EPN group （ P〈0.05 ）. The incidence rate of pulmonary infection, gastrointestinal symptoms, electrolyte disturbances in EEN group were lower than EPN group （ P〈0.05 ） .Conclusion EEN therapy has a better effect in severe cerebral infarction patients than EPN, which can more effectively improve the nutritional status and immune status of patients, and with higher safety.