不同胃肠营养支持方式对脑卒中吞咽困难患者的效果分析

Application effects of different gastrointestinal nutrition supporting in treatment of dysphagia in patients with cerebral stroke

目的探究吞咽困难脑卒中患者接受不同胃肠营养支持的应用效果。方法将吞咽困难的脑卒中患者100例,以双盲法随机为试验组和对照组,每组50例。对照组采用鼻胃管的方式实施胃肠营养支持,试验组采用鼻肠管的方式实施胃肠营养支持,观察2组脑卒中相关性肺炎(SAP)、腹泻、腹胀、呕吐深吸发生率,患者/家属满意率,干预前后血清白蛋白、前白蛋白水平,抗生素使用时间。结果试验组SAP发生率明显低于对照组(P<0.05);试验组满意率明显较对照组高(P<0.05);2组干预后的血清白蛋白、前白蛋白水平均较干预前升高,其中试验组干预后的血清白蛋白、前白蛋白水平高于对照组(P<0.05);试验组抗生素使用时间较对照组短,差异有统计学意义(P<0.05);试验组呕吐误吸发生率明显低于对照组,差异有统计学意义(P<0.05);2组腹泻、腹胀差异无统计学意义(P>0.05)。结论吞咽困难脑卒中患者接受胃肠管营养支持,可有效提高患者的蛋白水平和患者/家属的满意度,降低相关性肺炎及肠内营养相关并发症发生率和缩短抗生素使用时间。

Objective To investigate the application effects of different gastrointestinal nutrition supporting in treatment of dysphagia in patients with cerebral stroke.Methods A total of 100 patients with dysphagia due to cerebral stroke who were admitted and treated in our hospital from January 2019 to December 2019 were randomly divided into experimental group and control group,with 100 patients in each group.The patients in control group were treated by gastrointestinal nutrition supporting via nasogastric tube feeding,however,thepatients in experimental group were treated by gastrointestinal nutrition supporting via nasointestinal tube feeding.The SAP,the incidence of diarrhea,abdominal distension,vomiting aspiration,and satisfaction rate of patients/family members,and the changes of serum protein and prealbumin levels before and after intervention as well as antibiotics use duration were observed and compared between the two groups.Results The incidence rate of SAP in experimental group was significantly lower than that in control group,and the satisfaction rate of patients/family members in experimental group was significantly higher than that in control group(P<0.05).After intervention the serum levels of albumin and prealbumin in experimental group were significantly higher than those before intervention,moreover,which in experimental group were significantly higher than those in control group(P<0.05).The antibiotics use duration in experimental group was significantly shorter than that in control group(P<0.05).In addition the incidence rate of vomiting aspiration in experimental group was significantly lower than that in control group(P<0.05),but there were no significant differences in the incidence rates of diarrhea and abdominal distension between the two groups(P>0.05).Conclusion The gastrointestinal nutrition supporting in treatment of dysphagia due to cerebral stroke can effectively improve the protein level of patients and the satisfaction degree of patients/family members,reduce the incidence rate of associated pneumonia and enteral nutrition-related complications,and shorten the antibiotics use duration.