肠内营养支持治疗对急性心源性脑卒中伴吞咽功能障碍患者的临床疗效

Effect of enteral nutrition support on acute cardiogenic stroke patients with swallowing dysfunction

目的研究在传统肠内营养基础上添加益生菌制剂对急性心源性脑卒中伴吞咽功能障碍患者的临床疗效。方法选择2016年5月至2018年2月于哈励逊国际和平医院心血管内科及神经内科就诊的急性心源性脑卒中伴吞咽功能障碍患者140例,按照随机数字表法分为实验组和对照组,每组70例。对照组患者给予肠内营养支持治疗,实验组患者给予益生菌制剂联合肠内营养支持治疗。观察入院第1天和第14天两组患者的营养指标,包括血红蛋白(Hb);血清清蛋白(ALB)、总蛋白(TP)、前清蛋白(PA);同时观察神经功能评分和胃肠功能障碍评分及两组患者并发症的发生情况。结果入院后第1天两组患者营养指标、神经功能评分和胃肠功能障碍评分差异均无统计学意义(P>0.05)。治疗14d后,两组患者营养指标及神经功能评分和胃肠功能障碍评分均较第1天有所下降,对照组患者各指标水平下降程度低于实验组(P<0.05),同时对照组患者并发症发生率高于实验组(P<0.05)。结论传统肠内营养联合益生菌制剂能有效改善急性心源性脑卒中伴吞咽功障碍患者胃肠道功能,阻止患者营养不良进一步恶化,减少并发症,值得临床推广。

Objective To evaluate the clinical efficacy of conventional enteral nutrition based on probiotics in patients with acute cardiogenic stroke complicated with swallowing dysfunction.Methods 140 patients with acute cardio-cerebral stroke complicated with dysphagia admitted to our hospital from May 2016 to February2018were randomly divided into the observation group or control group,with 70 cases in each group.The control group was given enteral nutrition support while the observation group was treated with probiotics and enteral nutrition support.Nutritional indicators in both groups were observed at the day of admission and on the 14 th day,including hemoglobin(Hb),serum albumin(ALB),total protein(TP),prealbumin(PA),neurological scores,gastrointestinal dysfunction scores,and occurrence of complications.Results There were no significant differences in the four nutritional indicators,neurological function scores and gastrointestinal dysfunction scores on the first day after admission between the two groups(Ps>0.05).After 14 days of treatment,the nutritional and neurological function scores and gastrointestinal dysfunction scores in both groups decreased,and the degree of decline in the observation group was lower(P<0.05),while the incidence of complications in the control group was higher than that in the observation group(P<0.05).Conclusion Enteral nutrition combined with probiotics can effectively improve the gastrointestinal function of patients with acute cardiogenic stroke complicated with swallowing dysfunction,prevent further deterioration of malnutrition and reduce complications.