肠内营养乳剂营养支持治疗重症脑梗塞的临床效果

Clinical effect of enteral nutrition emulsion nutritional support in the treatment of severe cerebral infarction

目的 探究肠内营养乳剂营养支持治疗重症脑梗塞的疗效,寻找适合重症脑梗塞患者早期肠内营养支持的方案。方法 选取2019年12月至2022年12月驻马店市中心医院74例重症脑梗塞患者作为研究对象,均行早期肠内营养支持,根据营养剂不同分为两组,各37例。A组予以肠内营养乳剂营养支持,B组予以自制匀浆膳营养支持。检测对比两组治疗前后营养状态指标[总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)]、身体测量指标[肱三头肌皮褶厚度(TSF)、上臂肌围(AMC)]、外周血T细胞亚群(CD3~+、CD4~+、CD8~+)、生化指标[血糖(GLU)、谷丙转氨酶(ALT)、尿素氮(BUN)、血钾(K)、血钠(Na)、肌酐(Cr)]、不良反应发生率、预后指标。结果 A组治疗后血清TP、ALB、PA水平高于B组,差异有统计学意义(t=6.916、7.587、7.841,P<0.05);A组治疗前后TSF、AMC及GLU、ALT、BUN、K、Na、Cr水平与B组比较,差异均无统计学意义(t=0.568、0.286、0.574、0.114、0.117、0.061、0.297、1.022,P>0.05);A组治疗后CD3~+、CD4~+水平高于B组,差异有统计学意义(t=2.237、2.519,P<0.05);A组不良反应发生率(8.11%)低于B组(27.03%),差异有统计学意义(χ^(2)=4.573,P<0.05);A组住ICU时间、住院时间与B组比较,差异无统计学意义(t=1.115、0.937,P>0.05)。结论 与自制匀浆膳营养支持比较,采用肠内营养乳剂营养支持能进一步改善重症脑梗塞患者营养状态,提高机体免疫功能,且不良反应发生率低,是一种安全、高效的早期肠内营养支持方案。

Objective To explore the efficacy of enteral nutrition emulsion nutritional support in the treatment of severe cerebral infarction,find a suitable plan for early enteral nutrition support in patients with severe cerebral infarction.Methods From December 2019 to December 2022,74 patients with severe cerebral infarction in Zhumadian Central Hospital were selected as the research subjects,and all received early enteral nutrition support,according to different nutrients,they were divided into two groups,37 cases in each.Group A was given nutritional support for enteral nutrition emulsion,and group B was given nutritional sup-port for home-made homogenous meal.The nutritional status indicators[total protein(TP),albumin(ALB),prealbumin(PA)],body measurement indicators[thickness of triceps skin fold(TSF),upper arm muscle cir-cumference(AMC)],peripheral blood T cell subsets(CD3+,CD4+,CD8+),biochemical indicators[blood glucose(GLU),alanine aminotransferase(ALT),urea nitrogen(BUN),blood potassium(K),blood sodi-um(Na),creatinine(Cr)],incidence of adverse reactions,and prognostic indicators before and after treat-ment were compared between the two groups.Results After treatment,the serum levels of TP,ALB,and PA in Group A were higher than those in Group B,and the difference was statistically significant(t=6.916,7.587,7.841,P<0.05).There was no statistically significant difference in TSF,AMC,GLU,ALT,BUN,K,Na,Cr levels between Group A and Group B before and after treatment(t=0.568,0.286,0.574,0.114,0.117,0.061,0.297,1.022,P>0.05).The levels of CD3+and CD4+in group A were higher than those in group B,and the difference was statistically significant(t=2.237,2.519,P<0.05).The incidence of adverse reactions in group A(8.11%)was lower than that in group B(27.03%),and the difference was statistically significant(X^(2)=4.573,P<0.05).Compared with group B,the time of staying in ICU and hospitalization in group A was not statistically significant,and the difference was statistically significant(t=1.115,0.937,P>0.05).Conclusion Compared with the self-made homogenous diet nutrition support,the use of enteral nutrition emulsion nutrition support can further improve the nutritional status of patients with severe cerebral infarction and improve the immune function,and the incidence of adverse reactions is low,it is a safe and efficient early enteral nutrition support program.