重症高血压脑出血早期鼻饲肠内营养的临床研究

Clinical Research on Early Nasogastric Feeding after Severe Hypertensive Cerebral Hemorrhage

目的:探讨持续滴注的鼻饲方法作为重症高血压脑出血后早期肠内营养支持的临床应用和效果。方法:早期(发病后48～72h)持续滴注鼻饲要素膳综合治疗重症高血压脑出血患者51例(实验组,GCS评分4～8分)与按传统方法发病后7～8d鼻饲流质综合治疗的同类患者51例(对照组)比较。结果:GCS评分5分以上的病人能较好地耐守持续滴注的鼻饲营养方法。实验组血清白蛋白、体重等营养指标明显优于对照组(P<0.05～P<0.01),胃肠道并发症及其他并发症的发生率显著低于对照组(P<0.05～P<0.01),临床疗效也显著改善。结论:持续滴注的鼻饲营养可安全地用于重症高血压脑出血早期,且对维护胃肠道结构和功能,促进营养状态和预后恢复十分有利。

Objective:To evaluate the method and effect of nasogastric feeding as early nutritional support in severe hypertensive cerebral hemorrhage. Methods:51 patients of severe hypertensive cerebral hemorrhage were fed gastrically with the element diet within 48 - 72 hours after the onset of disease, as many patients nutritionally supported with common method on 7 - 8days were taken as control .Results: Evidence indicated that early nasogastric feeding regimens via continuous infusing was tolerated better in patients of GCS > 5. The serum albumin, body weight, nutritional index of the study group were significantly better than that of the control group ( P < 0.05- P < 0.01),the study group had a significantly favorable outcome by the end of 3 months. Conclusions: The early gastric feeding with enteral nutrition can be safely used in the severe hypertensive cerebral hemorrhage. It is beneficial to improve gut function, nutritional state and neurologic outcomes of the patients with severe hypertensive cerebral hemorrhage.