中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
z1期
1-4
,共4页
吴杨%于洋%刘家丰%侯宏伟%杨丛林
吳楊%于洋%劉傢豐%侯宏偉%楊叢林
오양%우양%류가봉%후굉위%양총림
肠内营养%益生菌%重症脑卒中
腸內營養%益生菌%重癥腦卒中
장내영양%익생균%중증뇌졸중
Enteral nutrition%Probiotics%Severe stroke
目的:观察早期肠内营养联合益生菌在急性重症脑卒中患者中应用的效果。方法选取87例急性重症脑卒中患者,随机分为对照组(47例)和研究组(40例),两组均在入院48~72 h内经鼻胃管开始肠内营养,研究组在肠内营养基础上添加益生菌。于入院第l、7及2l 天分别检测血红蛋白(Hb)、血清白蛋白(ALB)、前白蛋白(PLB)。观察第7、2l 天感染发生率以及胃肠道不良反应发生率。于第l、2l天进行GCS及NIHSS评分。结果入院第l天,两组ALB、PLB、Hb差异无统计学意义( P均>0.05);第7天,两组指标呈下降趋势,对照组下降明显[两组分别为:ALB:(3l.27±2.42)G/L 与(27.2l±2.69)G/L,P <0.00l;PLB:(0. l78±0.0ll)G/L 与(0. l65±0.023)G/L,P <0.00l;Hb:(ll2.4l±2.3l)G/L与(97. l3±l.79)G/L,P<0.00l];第2l天,两组指标出现上升趋势,研究组上升明显[两组分别为:ALB:(35.89±2.98)G/L与(30.24±2. ll)G/L,P<0.00l,PLB:(0.208±0.022)G/L与(0. l98±0.029)G/L,P<0.00l,Hb:(ll9. ll±3.42)G/L与(l08.36±2.63)G/L,P<0.00l]。入院第7天感染发生率及胃肠道不良反应发生率两组无差异,第2l天对照组感染及胃肠道不良反应发生率均较研究组高,两组分别为:肺炎:7例(l4.8%)与l4例(35.0%),χ2=4.467,P=0.035,肠道感染:2例(4.2%)与8例(20.0%),χ2=5.06l,P=0.024,呕吐:0与2例(5.0%),χ2=6.077,P=0.0l4,腹胀:5例(l0.6%)与ll例(27.5),χ2=3.859,P=0.049,腹泻:4例(8.5%)与l0例(25.0%),χ2=4. l27,P=0.042,菌群失调:4例(8.5%)与9例(22.5%),χ2=4. l53,P=0.046。第2l天两组GCS及NIHSS评分均较第l天提高,但两组间比较差异无统计学意义( P>0.05)。结论添加益生菌的肠内营养较单纯肠内营养,在提高机体营养状态、减轻感染和胃肠道不良反应方面优于后者。
目的:觀察早期腸內營養聯閤益生菌在急性重癥腦卒中患者中應用的效果。方法選取87例急性重癥腦卒中患者,隨機分為對照組(47例)和研究組(40例),兩組均在入院48~72 h內經鼻胃管開始腸內營養,研究組在腸內營養基礎上添加益生菌。于入院第l、7及2l 天分彆檢測血紅蛋白(Hb)、血清白蛋白(ALB)、前白蛋白(PLB)。觀察第7、2l 天感染髮生率以及胃腸道不良反應髮生率。于第l、2l天進行GCS及NIHSS評分。結果入院第l天,兩組ALB、PLB、Hb差異無統計學意義( P均>0.05);第7天,兩組指標呈下降趨勢,對照組下降明顯[兩組分彆為:ALB:(3l.27±2.42)G/L 與(27.2l±2.69)G/L,P <0.00l;PLB:(0. l78±0.0ll)G/L 與(0. l65±0.023)G/L,P <0.00l;Hb:(ll2.4l±2.3l)G/L與(97. l3±l.79)G/L,P<0.00l];第2l天,兩組指標齣現上升趨勢,研究組上升明顯[兩組分彆為:ALB:(35.89±2.98)G/L與(30.24±2. ll)G/L,P<0.00l,PLB:(0.208±0.022)G/L與(0. l98±0.029)G/L,P<0.00l,Hb:(ll9. ll±3.42)G/L與(l08.36±2.63)G/L,P<0.00l]。入院第7天感染髮生率及胃腸道不良反應髮生率兩組無差異,第2l天對照組感染及胃腸道不良反應髮生率均較研究組高,兩組分彆為:肺炎:7例(l4.8%)與l4例(35.0%),χ2=4.467,P=0.035,腸道感染:2例(4.2%)與8例(20.0%),χ2=5.06l,P=0.024,嘔吐:0與2例(5.0%),χ2=6.077,P=0.0l4,腹脹:5例(l0.6%)與ll例(27.5),χ2=3.859,P=0.049,腹瀉:4例(8.5%)與l0例(25.0%),χ2=4. l27,P=0.042,菌群失調:4例(8.5%)與9例(22.5%),χ2=4. l53,P=0.046。第2l天兩組GCS及NIHSS評分均較第l天提高,但兩組間比較差異無統計學意義( P>0.05)。結論添加益生菌的腸內營養較單純腸內營養,在提高機體營養狀態、減輕感染和胃腸道不良反應方麵優于後者。
목적:관찰조기장내영양연합익생균재급성중증뇌졸중환자중응용적효과。방법선취87례급성중증뇌졸중환자,수궤분위대조조(47례)화연구조(40례),량조균재입원48~72 h내경비위관개시장내영양,연구조재장내영양기출상첨가익생균。우입원제l、7급2l 천분별검측혈홍단백(Hb)、혈청백단백(ALB)、전백단백(PLB)。관찰제7、2l 천감염발생솔이급위장도불량반응발생솔。우제l、2l천진행GCS급NIHSS평분。결과입원제l천,량조ALB、PLB、Hb차이무통계학의의( P균>0.05);제7천,량조지표정하강추세,대조조하강명현[량조분별위:ALB:(3l.27±2.42)G/L 여(27.2l±2.69)G/L,P <0.00l;PLB:(0. l78±0.0ll)G/L 여(0. l65±0.023)G/L,P <0.00l;Hb:(ll2.4l±2.3l)G/L여(97. l3±l.79)G/L,P<0.00l];제2l천,량조지표출현상승추세,연구조상승명현[량조분별위:ALB:(35.89±2.98)G/L여(30.24±2. ll)G/L,P<0.00l,PLB:(0.208±0.022)G/L여(0. l98±0.029)G/L,P<0.00l,Hb:(ll9. ll±3.42)G/L여(l08.36±2.63)G/L,P<0.00l]。입원제7천감염발생솔급위장도불량반응발생솔량조무차이,제2l천대조조감염급위장도불량반응발생솔균교연구조고,량조분별위:폐염:7례(l4.8%)여l4례(35.0%),χ2=4.467,P=0.035,장도감염:2례(4.2%)여8례(20.0%),χ2=5.06l,P=0.024,구토:0여2례(5.0%),χ2=6.077,P=0.0l4,복창:5례(l0.6%)여ll례(27.5),χ2=3.859,P=0.049,복사:4례(8.5%)여l0례(25.0%),χ2=4. l27,P=0.042,균군실조:4례(8.5%)여9례(22.5%),χ2=4. l53,P=0.046。제2l천량조GCS급NIHSS평분균교제l천제고,단량조간비교차이무통계학의의( P>0.05)。결론첨가익생균적장내영양교단순장내영양,재제고궤체영양상태、감경감염화위장도불량반응방면우우후자。
Objective To observe the effect of early enteral nutrition combined with probiotics for acute severe stroke patients. Methods EiGhty-seven patients with acute severe stroke were randomly divided into control Group(47cases)and research Group(40 cases). Within 48 -72 h,both Groups were Given enternal nutrition,and research Group added probiotics on the basis of enternal nutrition. HemoGlobin( Hb ),serum albumin(ALB)and prealbumin(PLB)were detected on the lst,7th,2lth day after hospitalization. Infection incidence and the incidence of the Gastrointestinal adverse reaction were observed on the 7th,2lth day. GlasGow coma scale( GTS)and NeuroloGic impairment sccore( NIHSS)were assessed on the lst,2lth day. Results There were no satistical siGnificant differences between two Groups in terms of ALB,PLB and Hb on the first day after hospitalization(P>0. 05). The indicators of the two Groups occurred downward trend on the 7th day and control Group declined siGnificantly( The two Groups respectively:ALB:( 3l. 27 ±2. 42 ) G/L and( 27. 2l ±2. 69)G/L,P<0. 00l;PLB:(0. l78 ±0. 0ll)G/L and(0. l65 ±0. 023)G/L,P <0. 00l;Hb:(ll2. 4l ±2. 3l)G/L and(97. l3±l. 79)G/L,P<0. 00l). The two Groups occurred upward trend on the 2lth day and research Group rose siGnificantly( The two Groups respectively:ALB:( 35. 89±2. 98 )G/L and( 30. 24±2. ll ) G/L,P<0. 00l;PLB:(0. 208±0. 022)G/L and(0. l98±0. 029)G/L,P<0. 00l;Hb:(ll9. ll±3. 42)G/L and(l08. 36±2. 63)G/L,P<0. 00l). There were no statistical siGnificant differences between the two Group in terms of infection incidence and the Gastrointestinal adverse reaction on the 7th day. The incidence of control Group were hiGher than research Group on the 2lth day(The two Groups respectively:pneumonia:7(l4. 8%)and l4(35. 0%),χ2 =4. 467,P =0. 035;enteric infection:2(4. 2%)and 8(20. 0%),χ2 =5. 06l,P =0. 024;vomit:0 and 2(5%),χ2 =6. 077,P=0. 0l4;abdominal distension:5(l0. 6%)and ll(27. 5),χ2 =3. 859,P=0. 049;diarrhoea:4(8. 5%)and l0(25. 0%),χ2 =4. l27,P=0. 042;flora imbalance:4(8. 5l%)and 9 (22. 5%),χ2 =4. l53,P=0. 046). On the 2lth day,the GTS and NIHSS were hiGher than the first day,but there were no statistical sinificant differences between two Groups( P>0. 05). Conclusion Enteral nutrition add probiotics is superior to enteral nutrition on the aspects of enhancinG body nutrition situation,relievinG the infection and the Gastrointestinal adverse reaction.