基于NRS-2002指导下的营养支持对急性脑梗死患者营养状况影响分析

Influence of Nutritional Support Under The Guidance of NRS-2002 on Nutritional Status of Patients with Acute Cerebral Infarction

目的:探讨基于NRS-2002指导下的营养支持对急性脑梗死患者营养状况影响;方法:选取2021年3月—2022年11月在我院住院治疗的106例急性脑梗死患者,随机分为2组,各53例,对照组根据APACHEⅡ评分给予早期肠外营养支持,观察组给予基于NRS-2002指导下的营养支持,治疗30d,观察两组营养状况、神经功能恢复、胃肠道反应及预后情况。结果:治疗30d后,两组的血清TP、ALB、Hb均明显升高(P<0.05);组间比较显示,治疗30d后研究组血清TP、ALB、Hb水平明显高于对照组,差异有统计学意义(P<0.05);对照组治疗期间主要出现呕吐、腹泻、便秘、胃肠道出血等并发症,总发生率为20.75%(11/53);研究组胃肠道并发症以呕吐、便秘为主,总发生率为3.77%(2/53),研究组胃肠道发生明显低于对照组,差异有统计学意义(P<0.05);两组治疗后2周、1个月NIHSS评分均较治疗前明显下降(P<0.05),组间比较,研究组治疗2周、1个月的NIHSS评分均明显低于对照组,差异有统计学意义(P<0.05);观察组预后不良率7.55%(4/53)明显低于对照组24.53%(13/53),差异有统计学意义(χ^(2)=5.675,P=0.017)。结论:NRS-2002指导下的营养支持能改善患者营养状况,减轻胃肠道反应,并有助于神经功能恢复,是急性脑梗死患者个体化营养管理的可靠方法。

【Objective】To explore the effect of nutritional support under the guidance of NRS-2002 on the nutritional status of patients with acute cerebral infarction.【Method】Totally 106 patients with acute cerebral infarction who were hospitalized in our hospital from March 2021 to November 2022 were randomly divided into two groups,53 patients in each group.The control group was given early parenteral nutrition support according to APACHEⅡ score,and the observation group was given nutritional support under the guidance of NRS-2002.After 30 days of treatment,the nutritional status,neurological function recovery,gastrointestinal reaction and prognosis of the two groups were ob-served.【Result】After 30 days of treatment,the levels of serum TP,ALB and Hb in the two groups were significantly higher(P<0.05).During the treatment,the main complications in the control group were vomiting,diarrhea,constipation,gastrointestinal bleeding,and the total incidence was 20.75%(11/53).The main gastrointestinal complications in the study group were vomiting and constipation,with a total incidence of 3.77%(2/53).The incidence of gastrointestinal complications in the study group was significantly lower than that in the control group(P<0.05).The NIHSS score of the two groups at 2 weeks and 1 month after treatment was significantly lower than that before treatment(P<0.05).The poor prognosis rate in the observation group was 7.55%(4/53),which was significantly lower than that in the control group(24.53%,13/53),and the difference was statistically significant(χ^(2)=5.675,P=0.017).【Conclusion】Nutritional support under the guidance of NRS-2002 can improve the nutritional status of patients,reduce gastrointestinal reactions,and help to recover neurological function.It is a reliable method for individualized nutritional management of patients with acute cerebral infarction.