采用肠内与肠外营养支持治疗早期重症脑卒中患者的效果观察

Observation on the effect of enteral and parenteral nutrition support in the treatment of early severe stroke patients

目的比较肠内与肠外营养支持治疗早期重症脑卒中患者的效果。方法前瞻性选取上海市浦东新区人民医院2017年3月至2018年11月收治的70例早期重症脑卒中患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各35例。观察组给予患者肠内营养支持,对照组给予患者肠外营养支持。检测并比较2组患者治疗前、治疗后7、14 d血清丙氨酸氨基转移酶(ALT)、血清肌酐(SCr)、简化临床肺部感染量表(CPIS)评分、格拉斯哥昏迷指数(GCS)评分以及ICU住院时间、住院费用和并发症。结果治疗后7、14 d,2组患者ALT水平均高于本组治疗前,且观察组ALT水平低于同期对照组,差异有统计学意义(P<0.05)。治疗后,2组CPIS评分低于本组治疗前,且GCS评分均高于本组治疗前,且观察组较对照组改善更明显,2组比较,差异有统计学意义(P<0.05)。观察组ICU住院时间为(3.95±1.36)d短于对照组的(6.18±1.77)d,住院费用为(1.23±0.38)万元低于对照组的(2.13±0.56)万元,差异有统计意义(P<0.05)。观察组不良反应总发生率为22.86%,低于对照组的51.43%,差异有统计意义(P<0.05)。结论肠内营养支持在改善CPIS和GCS评分、降低并发症发生率方面显著优于肠外营养,有利于早期重症脑卒中患者机体与神经功能恢复,值得临床予以推广。

Objective To compare the effects of enteral and parenteral nutrition support in the treatment of early severe stroke patients.Methods Seventy early severe stroke patients admitted to Shanghai Pudong New Area People's Hospital from March 2017 to November 2018 were selected as the research objects,and were divided into observation group and control group according to the random number table method,with 35 cases in each group.The observation group was given enteral nutrition support,and the control group was given parenteral nutrition support.Detect and compare the two groups of serum alanine aminotransferase(ALT),serum creatinine(SCr),simplified clinical lung infection scale(CPIS)score,Glasgow coma index(GCS)score,ICU length of stay,hospitalization expenses and complications disease.Results At 7 d and 14 d after treatment,the ALT levels of the two groups were higher than those before the treatment,and the ALT levels of the observation group were lower than those of the control group during the same period,the difference was statistically significant(P<0.05).After treatment,the CPIS scores were lower than those of the group before treatment,and the GCS scores of the two groups were higher than those of the group before treatment,and the difference between the two groups was statistically significant(P<0.05).The length of ICU stay in the observation group was(3.95±1.36)days shorter than that of the control group(6.18±1.77)days,and the hospitalization expenses was(1.23±0.38)million yuan,which was lower than the observation group(2.13±0.56)million yuan.The differences were statistically significant significance(P<0.05).The total incidence of adverse reactions in the observation group was 22.86%,which was lower than 51.43%in the control group,and the difference was statistically significant(P<0.05).Conclusion Enteral nutrition support is significantly better than parenteral nutrition in improving CPIS and GCS scores and reducing the incidence of complications,which is beneficial to the recovery of body and nerve function in patients with early severe stroke,and is worthy of clinical promotion.