鼻饲管联合精细护理对脑卒中患者肠内营养和肺部感染的影响

Effects of nasal feeding tube combined with careful nursing on enteral nutrition and pulmonary infection in patients with cerebralstroke

目的探讨鼻饲管联合精细护理对脑卒中患者肠内营养和肺部感染的影响。方法将2016年4月～2018年3月辽宁省大连市中心医院神经内科收治的116例脑卒中患者,按随机数字表法将其分为对照组和观察组,每组各58例。对照组给予鼻饲管联合常规护理治疗,观察组给予鼻饲管联合精细护理治疗,比较两组患者护理后的营养指标、免疫水平、美国国立卫生研究院卒中量表评分(NIHSS)和肺感染率。结果护理后,两组患者的营养指标均较护理前上升,且观察组患者的营养指标高于对照组,差异有统计学意义(P <0.05);两组患者的IgG、IgA和IgM水平均较护理前下降,但观察组患者的IgG、IgA和IgM水平高于对照组,差异有统计学意义(P <0.05);两组患者的NIHSS评分均较护理前下降,且观察组患者的NIHSS评分低于对照组,差异有统计学意义(P <0.05);观察组肺部感染率为10.31%,明显低于对照组(25.90%),差异有统计学意义(P <0.05)。结论鼻饲管联合精细护理能保证脑卒中患者体内的营养供给,抵抗机体的应激作用及降低肺部感染发生,促进患者的免疫功能和神经功能恢复。

Objective To explore the effects of nasal feeding tube combined with careful nursing on enteral nutrition and pulmonary infection in cerebralstroke patients. Methods From April 2016 to March 2018, 116 patients with cerebralstroke admitted into the Department of Nursing in Dalian Central Hospital were divided into control group and observation group according to random number table method, with 58 cases in each group. The control group was given nasal feeding tube combined with routine nursing treatment, and the observation group was given nasal feeding tube combined with careful nursing treatment. The nutrition index, immunity level, the score of national institutes of health stroke scale score (NIHSS) and the rate of pulmonary infection were compared between the two groups. Results After nursing, the levels of nutritional indicators in the two groups all increased, and those in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The levels of IgG, IgA and IgM all descended, and the levels of IgG, IgA and IgM in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The NIHSS scores of patients in both groups were lower than those before nursing, and the NIHSS scores of patients in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). The rate of pulmonary infection in the observation group was 10.31%, which was significantly lower than that 25.90% in the control group, the difference was statistically significant (P < 0.05). Conclusion Nasal feeding tube combined with fine nursing can ensure the nutrition supply in stroke patients, resist the stress effect of the body, reduce the occurrence of pulmonary infection, and promote the recovery of patients′ immune function and neurological function.