鼻饲肠内营养支持对急性脑卒中康复的影响

Effects of enteral nutritional supplementation via a nasogastric tube on the complications and rehabilitation following acute stroke

目的 探讨鼻肠内营养支持对脑卒中后感染性并发症的影响及对卒中后营养状况恶化和神经功能缺损康复的治疗作用。方法 收集伴有吞咽障碍的急性脑卒中住院病例 70例 ,给予鼻肠内营养支持治疗 ,其余治疗措施相同。评估不同时间点的营养状况和神经功能缺损程度 ,记录感染性并发症的发生和持续时间以及吞咽障碍的持续时间。结果 ( 1)鼻肠内营养支持组的营养状况恶化的程度明显比未给予鼻肠内营养支持组的轻。 ( 2 )鼻肠内营养支持组的感染性并发症的发生率及持续时间均较未给予鼻肠内营养支持组低和短 ,尤其可降低肺部感染和多脏器的混合感染的发生率。 ( 3)在相同病程内神经功能缺损康复的程度鼻肠内营养支持组较未给予鼻肠内营养支持组好。结论 ( 1)鼻肠内营养支持有利于改善卒中后的营养状况和神经功能的恢复。 ( 2 )鼻肠内营养支持通过改善营养状况、减少吸入性肺炎的发生 ,及增强机体抵抗力达到降低。

Objective To study the effects of enteral nutritional supplementation via a nasogastric tube(ENS)on the infective complication,the nutrition deterioration and the neurological deficit rehabilitation after acute stroke.Methods This study included 70 hospitalized dysphagia patients with an acute stroke of less than 24 hours duration.Patients were treated randomly with ENS or without ENS(UENS).The other treatments of all patients were the same.To assess the frequency and history of infective complication,the nutrition and the neurological deficit at different time after stroke.Results 1.The extent of nutriture deterioration was significantly lower in the ENS group than in the UENS group.2.The frequency and the history of infective complication were significantly lower and shorter in the ENS group than in the UENS group.3.During the same duration after acute stroke,the rehabilitation of neurological deficit was significantly better in the ENS group than in the UENS group. Conclusions (1)ENS is helpful for increasing rehabilitation of neurological deficit and blocking deterioration of nutriture in the dysphagia patients following acute stroke.(2)ENS can reduce the frequency and the history of infective complication in the dysphagia patients following acute stroke.