医护治一体化介入对脑卒中鼻饲患者营养状况和免疫功能的影响

Effect of integration of medical care and treatment on the nutritional status and immune function of patients subjected to nasogastric feeding after having suffered stroke

目的观察医护治一体化介入对脑卒中鼻饲患者营养状况和免疫功能的影响,探讨其应用价值。方法106例脑卒中鼻饲患者随机分为对照组和研究组,分别采用常规的医护方案和医护治一体化方案。对比两组治疗前后的不良情绪评分及鼻饲并发症;分别于治疗前后测定患者血清总蛋白、白蛋白、血红蛋白水平,外周血CD3+T细胞、CD4+T细胞及CD8+T细胞水平,血清免疫球蛋白IgA、IgM、IgG水平。结果研究组鼻饲并发症发生率(33.96%)低于对照组(54.72%),差异有统计学意义(χ^2=4.625,P=0.032)。治疗前,两组的SDS评分、SAS评分,血清总蛋白、白蛋白、血红蛋白水平,外周血CD3+T细胞、CD4+T细胞、CD8+T细胞计数及血清IgA、IgM、IgG水平差异均无统计学意义(P>0.05);治疗后,除血红蛋白水平外,其余各项指标两组均有明显改善,且研究组明显优于对照组,差异均有统计学意义(P<0.05)。结论医护治一体化能够提高脑卒中鼻饲效果和降低并发症,对改善患者营养状况和免疫功能有积极意义。

Objective To evaluate the efficacy and clinical value of a model of integration of intervention of medical care and treatment on the nutritional status and immune function of patients being subjected to nasogastric feeding in the wake of stroke. Methods Firstly, 106 patients being subjected to nasogastric feeding after having suffered stroke were randomly divided into a control group and an experimental group. The two groups were then administered with conventional care and integration of medical care and treatment respectively. The negative mood score and complications resulting from nasogastric feeding as observed in the two groups before and after intervention were compared. Serum total protein, albumin, hemoglobin levels, peripheral blood CD 3 + T cell, CD 4 + T cell and CD 8 + T cell count, serum immunoglobulin IgA, IgM and IgG levels of the two groups before and after treatment were lastly measured. Results The rate of incidence of complications of the experimental group (33.96%) was lower than that of the control (54.72%). The difference was statistically significant (χ^2 =4.625, P =0.032). Before treatment, no significant difference was found between the two groups in SDS score, SAS score, serum total protein, albumin, hemoglobin level, peripheral blood CD 3 + T cell, CD 4 + T cell, CD 8 + T cell count and serum IgA, IgM and IgG levels ( P >0.05). After treatment, all the indicators except hemoglobin level were significantly improved in both groups, with those of the experimental group being significantly superior to those of the control group. The differences were statistically significant ( P <0.05). Conclusions Integration of medical care and treatment as an intervention model could effectively improve nasogastric feeding after stroke and reduce complications and can as well improve the nutritional status and immune function of the patients.