营养支持联合早期肺康复锻炼对脑卒中气管切开患者的影响

Effects of Nutrition Support Combined with Early Pulmonary Rehabilitation Exercise on Stroke Patients Undergoing Tracheotomy

目的:探讨营养支持联合早期肺康复锻炼对脑卒中气管切开患者的影响。方法:选取2017年1月1日~2018年6月30日70例脑卒中气管切开患者作为对照组,给予常规护理。选取2018年7月1日~2020年1月31日70例脑卒中气管切开患者作为观察组,在常规护理基础上实施营养支持联合早期肺康复锻炼。比较两组干预效果。结果:观察组带管时间短于对照组(P<0.05),复置管率低于对照组(P<0.05);两组干预1个月后血清转铁蛋白(TRF)、前白蛋白(PA)、白蛋白(ALB)水平高于干预前(P<0.05),观察组干预1个月后TRF、PA、ALB水平高于对照组(P<0.05);两组干预1个月后APACHEⅡ评分、美国国立卫生院卒中量表(NIHSS)评分低于干预前(P<0.05),观察组干预1个月后APACHEⅡ评分、NIHSS评分低于对照组(P<0.05);观察组营养不良、肺部感染、腹泻、上消化道出血发生率低于对照组(P<0.05)。结论:营养支持联合早期肺康复锻炼能改善脑卒中气管切开患者的营养状况,缩短带管时间,减少复置管,减轻神经损伤,降低肺部感染等并发症发生风险,改善预后。

Objective:To investigate the effect of nutrition support combined with early pulmonary rehabilitation exercise on stroke patients undergoing tracheotomy.Methods:From January 1,2017 to June 30,2018,70 stroke patients with tracheotomy were selected as the control group and given routine nursing care.From July 1,2018 to January 31,2020,70 stroke patients with tracheotomy were selected as the observation group,and nutrition support combined with early pulmonary rehabilitation exercise was implemented on the basis of routine nursing.The effects of intervention were compared between the two groups.Results:The time with catheter in the observation group was shorter than that in the control group(P<0.05),and the catheter re-placement rate was lower than that in the control group(P<0.05).Serum transferrin(TRF),prealbumin(PA)and albumin(ALB)levels were higher in the two groups after 1 month of intervention than before(P<0.05),while TRF,PA and ALB levels in the observation group were higher than those in the control group after 1 month of intervention(P<0.05).The APACHEⅡscore and the U.S.national institutes of health stroke scale(NIHSS)score of the two groups after 1 month of intervention were lower than that of before intervention(P<0.05),and the APACHEⅡscore and NIHSS score in the observation group after 1 month of intervention were lower than that of the control group(P<0.05).The incidence of malnutrition,pulmonary infection,diarrhea and upper gastrointestinal bleeding in the observation group was lower than that in the control group(P<0.05).Conclusion:Nutrition support combined with early pulmonary rehabilitation exercise can improve the nutritional status of stroke patients undergoing tracheotomy,shorten the time of catheter re-placement,reduce the risk of nerve injury,decrease pulmonary infection and other complications,and improve the prognosis.