疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2015年
2期
125-128
,共4页
肠内营养支持%早期%脑卒中%急性%心脑综合征%近期结局%相关性
腸內營養支持%早期%腦卒中%急性%心腦綜閤徵%近期結跼%相關性
장내영양지지%조기%뇌졸중%급성%심뇌종합정%근기결국%상관성
Enteral nutrition support,early%Cerebral stroke,acute%Cardio-cerebral syndrome%Short-term out-come%Correlation
目的：探讨早期肠内营养支持与急性脑卒中致心脑综合征近期结局的关系。方法2010年1月—2014年1月神经内科收治急性脑卒中致心脑综合征患者100例,发病<72 h,均经颅脑CT 或MR确诊。随机分为观察组和对照组各50例,观察组给予早期肠内营养支持,对照组给予肠外营养支持,对比分析2组患者临床疗效、营养支持前后营养指标、免疫指标及并发症情况。结果观察组患者总有效率92.0%高于对照组的72.0%(χ2=6.18, P =0.016)。观察组治疗第1天直至治疗结束,血红蛋白、总蛋白、白蛋白、前白蛋白等营养指标均逐渐降低,但治疗第10、21天各项营养指标变化与治疗第1天比较差异均无统计学意义( P >0.05)；对照组患者治疗第1天直至治疗结束,各项营养指标均逐渐降低,治疗第10、21天各项营养指标变化与治疗第1天比较差异均有统计学意义( P <0.05)；治疗21天后,血红蛋白、总蛋白、白蛋白等营养指标变化观察组与对照组比较差异均有统计学意义( P <0.05)。观察组治疗第1天直至治疗结束,总淋巴细胞计数(TLC)、IgA、IgG、IgM、C3、C4等免疫指标均逐渐降低,但治疗第10、21天各项免疫指标与治疗第1天比较差异均无统计学意义( P >0.05)；对照组治疗第1天直至治疗结束,各项免疫指标均逐渐降低,治疗第10、21天TLC、IgA、IgG、C3等免疫指标与治疗第1天比较差异均有统计学意义( P <0.05)；观察组患者治疗21天后TLC、IgA、IgG、C3等免疫指标与对照组比较差异均有统计学意义( P <0.05)。观察组患者治疗过程中发生感染2例,低蛋白血症5例,对照组患者中发生感染9例,褥疮6例,低蛋白血症8例,2组患者并发症发生率比较差异有统计学意义(χ2=4.23, P =0.039)。结论早期肠内营养能明显改善急性脑卒中致心脑综合征患者的营养状态,对提高机体免疫力、促进康复均有积极意义。
目的：探討早期腸內營養支持與急性腦卒中緻心腦綜閤徵近期結跼的關繫。方法2010年1月—2014年1月神經內科收治急性腦卒中緻心腦綜閤徵患者100例,髮病<72 h,均經顱腦CT 或MR確診。隨機分為觀察組和對照組各50例,觀察組給予早期腸內營養支持,對照組給予腸外營養支持,對比分析2組患者臨床療效、營養支持前後營養指標、免疫指標及併髮癥情況。結果觀察組患者總有效率92.0%高于對照組的72.0%(χ2=6.18, P =0.016)。觀察組治療第1天直至治療結束,血紅蛋白、總蛋白、白蛋白、前白蛋白等營養指標均逐漸降低,但治療第10、21天各項營養指標變化與治療第1天比較差異均無統計學意義( P >0.05)；對照組患者治療第1天直至治療結束,各項營養指標均逐漸降低,治療第10、21天各項營養指標變化與治療第1天比較差異均有統計學意義( P <0.05)；治療21天後,血紅蛋白、總蛋白、白蛋白等營養指標變化觀察組與對照組比較差異均有統計學意義( P <0.05)。觀察組治療第1天直至治療結束,總淋巴細胞計數(TLC)、IgA、IgG、IgM、C3、C4等免疫指標均逐漸降低,但治療第10、21天各項免疫指標與治療第1天比較差異均無統計學意義( P >0.05)；對照組治療第1天直至治療結束,各項免疫指標均逐漸降低,治療第10、21天TLC、IgA、IgG、C3等免疫指標與治療第1天比較差異均有統計學意義( P <0.05)；觀察組患者治療21天後TLC、IgA、IgG、C3等免疫指標與對照組比較差異均有統計學意義( P <0.05)。觀察組患者治療過程中髮生感染2例,低蛋白血癥5例,對照組患者中髮生感染9例,褥瘡6例,低蛋白血癥8例,2組患者併髮癥髮生率比較差異有統計學意義(χ2=4.23, P =0.039)。結論早期腸內營養能明顯改善急性腦卒中緻心腦綜閤徵患者的營養狀態,對提高機體免疫力、促進康複均有積極意義。
목적：탐토조기장내영양지지여급성뇌졸중치심뇌종합정근기결국적관계。방법2010년1월—2014년1월신경내과수치급성뇌졸중치심뇌종합정환자100례,발병<72 h,균경로뇌CT 혹MR학진。수궤분위관찰조화대조조각50례,관찰조급여조기장내영양지지,대조조급여장외영양지지,대비분석2조환자림상료효、영양지지전후영양지표、면역지표급병발증정황。결과관찰조환자총유효솔92.0%고우대조조적72.0%(χ2=6.18, P =0.016)。관찰조치료제1천직지치료결속,혈홍단백、총단백、백단백、전백단백등영양지표균축점강저,단치료제10、21천각항영양지표변화여치료제1천비교차이균무통계학의의( P >0.05)；대조조환자치료제1천직지치료결속,각항영양지표균축점강저,치료제10、21천각항영양지표변화여치료제1천비교차이균유통계학의의( P <0.05)；치료21천후,혈홍단백、총단백、백단백등영양지표변화관찰조여대조조비교차이균유통계학의의( P <0.05)。관찰조치료제1천직지치료결속,총림파세포계수(TLC)、IgA、IgG、IgM、C3、C4등면역지표균축점강저,단치료제10、21천각항면역지표여치료제1천비교차이균무통계학의의( P >0.05)；대조조치료제1천직지치료결속,각항면역지표균축점강저,치료제10、21천TLC、IgA、IgG、C3등면역지표여치료제1천비교차이균유통계학의의( P <0.05)；관찰조환자치료21천후TLC、IgA、IgG、C3등면역지표여대조조비교차이균유통계학의의( P <0.05)。관찰조환자치료과정중발생감염2례,저단백혈증5례,대조조환자중발생감염9례,욕창6례,저단백혈증8례,2조환자병발증발생솔비교차이유통계학의의(χ2=4.23, P =0.039)。결론조기장내영양능명현개선급성뇌졸중치심뇌종합정환자적영양상태,대제고궤체면역력、촉진강복균유적겁의의。
Objective To investigate the relationship between early enteral nutrition support and acute stroke in-duced cardio-cerebral syndrome in short term. Methods From 2010 January to 2014 January, 100 acute stroke patients in the department of neurology were enrolled, symptom occurred less than 72 h, disease was confirmed by cranio-cerebral CT or MR. They were randomly divided into observation group and control group with 50 cases in each group, the observation group re-ceived early enteral nutrition support, the control group were given parenteral nutrition support, comparative analysis between the 2 groups of patients were performed before and after clinical treatment, nutritional index, immune index and complications were compared. Results In the observation group, the total efficiency is 92. 0%, which is higher than that of the control group 72. 0% (χ2 =6. 18, P =0. 016). After the first day treatment, the observation group’s hernoglobulin, total protein, albumin, prealbumin as nutritional index were gradually reduced, but no significant differences of these nutritional indexes were found at 10th and 21st day of treatment from 1st day ( P >0. 05);After the first day treatment, the control group’s nu-tritional indexes were gradually reduced, significant differences of these nutritional indexes were found at 10th and 21st day of treatment from 1st day ( P <0. 05);21 days after treatment, hemoglobin, total protein, albumin and other nutritional indica-tors’ change in the observation group were significantly different from the control group ( P <0. 05). After the first day treat-ment, the observation group’ s total lymphocyte count ( TLC) , IgA, IgG, IgM, C3 , C4 immune indexes were gradually re-duced,but no significant differences of these immune indexes were found at 10th and 21st day of treatment from 1st day( P >0. 05);After the first day treatment, control group’s immunological indexes were gradually reduced, significant differences of TLC, IgA, IgG, C3 were found at 10th and 21st day of treatment from 1st day ( P <0. 05); after 21 days’ treatment, the observation group’s TLC, IgA, IgG, C3 etc. immune index were significantly different from the control group ( P <0. 05). Infection occurred in 22 patients in the observation group in the course of treatment, 5 patients with hypoproteinemia, control group’ s infection occurred in 9 patients, 6 cases of bedsore, hypoproteinemia in 8 cases, the complication rate between the 2 groups revealed statistical differences (χ2 =4. 23, P =0. 039). Conclusion Early enteral nutrition can improve the nutri-tional status of acute stroke comprehensive syndrome patients with cardio-cerebral syndrome, is helpful for improving immunity and rehabilitation.
