序贯式肠内营养在脑梗死伴吞咽障碍老年患者中的应用

Application of Sequential Enteral Nutrition in Elderly Patients with Cerebral Infarction and Dysphagia

目的:探讨序贯式肠内营养在脑梗死伴吞咽障碍老年患者中的应用效果。方法:采用随机抽样法选取在某三级甲等医院卒中单元住院的脑梗死老年患者95例,随机分为观察组48例和对照组47例。观察组先采用短肽型肠内营养制剂,并逐步过渡到整蛋白型肠内营养剂;对照组在整个研究过程中一直使用整蛋白型肠内营养剂。比较两组肠内营养并发症发生情况,于入院第2、14天比较两组神经功能指标恢复情况[采用美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)]及吞咽功能分级(采用洼田饮水试验)。结果:观察组肠道感染、肺部感染、尿道感染、胃出血等并发症总发生率低于对照组(P<0.05);入院第14天,观察组NIHSS评分低于对照组(P<0.05),吞咽功能分级优于对照组(P<0.05)。结论:序贯式肠内营养支持能够降低脑梗死老年患者肠内营养并发症发生率,促进神经功能和吞咽功能恢复,值得临床推广应用。

Objective:To investigate the effect of sequential enteral nutrition in elderly patients with cerebral infarction and dysphagia.Methods:A total of 95 elderly patients with cerebral infarction who were hospitalized in the stroke unit of a Grade 3 Class A hospital were selected by random sampling,and randomly divided into observation group(48 cases)and control group(47 cases).In the observation group,the short peptide enteral nutrition preparation was first used,and was gradually transferred to the euprotein-type enteral nutrition.The control group was treated with euprotein-type enteral nutrients throughout the study.The incidence of enteral nutrition complications was compared between the two groups,and the recovery of neurological function indexes[NIHSS,Barthel index(BI)]and swallowing function grading(Water swallow test)were compared between the two groups at 2 and 14 days after admission.Results:The total incidence of intestinal infection,pulmonary infection,urinary tract infection and gastric bleeding in the observation group was lower than that in the control group(P<0.05).On the 14th day after admission,NIHSS score of the observation group was lower than that of the control group(P<0.05),and the grade of swallowing function was better than that of the control group(P<0.05).Conclusion:Sequential enteral nutrition support can reduce the incidence of enteral nutrition complications in elderly patients with cerebral infarction and promote the recovery of nerve function and swallowing function.It is worthy of clinical application.