不同营养风险脑梗死患者限制热量肠内营养疗效及预后分析

Analysis of the efficacy and prognosis of calorie restriction enteral nutrition in patients with cerebral infarction at different nutritional risks

目的探讨限制热量的肠内营养应用于不同营养风险的脑梗死患者的临床疗效。方法2018年1月~2019年10月收集我院脑梗死患者105例,其中高度营养风险42例、中度营养风险63例。采用分层随机法分为观察组和对照组。观察组给予限制热量肠内营养,第1周目标热量为标准化热量的60%~70%;对照组给予标准化热量肠内营养,第1周目标热量为标准化热量的90%~100%。营养支持7d后,观察两组中不同营养风险患者的营养指标、喂养并发症发生率及预后情况。结果营养支持7d后,观察组中度营养风险患者营养指标均低于对照组(P<0.05);住院时间、出院神经功能缺损评分(NIHSS)高于对照组,出院日常生活活动能力(BI指数)低于对照组(P<0.05)。观察组高度营养风险患者营养指标均高于对照组(P<0.05),腹泻、电解质紊乱、医院获得性感染的发生率低于对照组(P<0.05);住院时间、出院NIHSS评分低于对照组,出院BI指数高于对照组(P<0.05)。结论中度营养风险脑梗死患者选择限制热量肠内营养,营养状态及预后相对较差,增加住院时间;而高度营养风险患者选择限制热量能提高营养状态,减少喂养并发症,缩短住院时间,改善预后。

Objective To explore the clinical efficacy of caloric restriction enteral nutrition in patients with cerebral infarction at different nutritional risks.Methods A total of 105 patients with cerebral infarction were included in the studyfrom January 2018 to October 2019.63 patients with moderate nutritional risk of cerebral infarction and 42 patients with high nutritional risk of cerebral infarction were randomly assigned to the observation group and the control group.The target calories of the observation group were 60%to 70%of the standardized calories.The control group were 90%to 100%of the standard heat.After 7 days of nutritional support,the nutritional indicators,incidence of feeding complications and prognosis of patients with different nutritional risks were observed in the two groups.Results After 7 days of nutritional support,in patients at moderate nutritional risk,the observation group had lower nutritional indicators than the control group(P<0.05);Hospitalization time and discharge NIHSS score in the observation group were higher than those in the control group,and discharge BI index was lower than that in the control group(P<0.05).Among patients with high nutritional risk,the observation group had higher nutritional indicators than the control group(P<0.05)The incidence of diarrhea,electrolyte disturbance and hospital-acquired infection in the observation group was lower than that in the control group(P<0.05);Hospitalization time and discharge NIHSS score in the observation group were lower than those in the control group,and discharge BI index was higher than that in the control group(P<0.05).Conclusion In patients with moderate nutritional risk,caloric restriction is selected for enteral nutrition,and the nutritional status and prognosis are relatively poor,which increase the length of hospital stay.Calorie restriction improve nutritional status,reduce feeding complications,shorten hospital stay,and improve prognosis in patients with high nutritional risk.