CAJ | 학술논문

目的：探讨自制匀浆液应用于脑卒中患者肠内营养的效果。方法将200例中度、严重脑卒中患者根据患者家属意愿分为A组（n＝60）和B组（n＝85）和C组（n＝55）。 A组接受自制匀浆液肠内营养支持和护理，B组接受瑞素肠内营养支持和护理，C组采用家属自备流食进行营养支持和护理。统计分析3组患者营养支持前后总蛋白、白蛋白、前白蛋白等营养指标以及营养风险筛查（NRS－2002）评分、生活质量评分、神经功能缺损评分（NIHSS）和格拉斯哥昏迷评分（GCS），并观察患者不良反应和并发症的发生情况。结果3组患者营养支持前总蛋白、白蛋白、前白蛋白、NRS－2002评分、生活质量评分、NIHSS评分和GCS评分比较差异无统计学意义，A组和B组营养支持后总蛋白、白蛋白、前白蛋白、NRS－2002评分、生活质量评分、NHISS评分和GCS评分以及不良反应和并发症发生率比较差异亦无统计学意义（ P＞0.05）。 C组营养支持后总蛋白、白蛋白、前白蛋白均低于A组和B组，差异有统计学意义（ P＜0.05）。 C组营养支持后躯体功能、总体健康、活力等8个维度的生活质量评分均低于A组和B组，差异有统计学意义（ P＜0.05）。 C组营养支持后NIHSS评分、NRS－2002评分高于A组、B组，而GCS评分低于A组和B组；而C组不良反应和并发症的发生率为18.18％，高于A组的5.00％和B组的5.88％，差异有统计学意义（ P＜0.05）。结论脑卒中患者肠内营养采用自制匀浆液并进行相应的护理，可取得与商品营养液相似的效果，可改善脑卒中患者的营养状况、认知功能，促进患者肢体能力的恢复，改善患者的预后，显著提高患者的生活质量，并降低不良反应和并发症的发生率，值得临床推广使用。
목적：탐토자제균장액응용우뇌졸중환자장내영양적효과。방법장200례중도、엄중뇌졸중환자근거환자가속의원분위A조（n＝60）화B조（n＝85）화C조（n＝55）。 A조접수자제균장액장내영양지지화호리，B조접수서소장내영양지지화호리，C조채용가속자비류식진행영양지지화호리。통계분석3조환자영양지지전후총단백、백단백、전백단백등영양지표이급영양풍험사사（NRS－2002）평분、생활질량평분、신경공능결손평분（NIHSS）화격랍사가혼미평분（GCS），병관찰환자불량반응화병발증적발생정황。결과3조환자영양지지전총단백、백단백、전백단백、NRS－2002평분、생활질량평분、NIHSS평분화GCS평분비교차이무통계학의의，A조화B조영양지지후총단백、백단백、전백단백、NRS－2002평분、생활질량평분、NHISS평분화GCS평분이급불량반응화병발증발생솔비교차이역무통계학의의（ P＞0.05）。 C조영양지지후총단백、백단백、전백단백균저우A조화B조，차이유통계학의의（ P＜0.05）。 C조영양지지후구체공능、총체건강、활력등8개유도적생활질량평분균저우A조화B조，차이유통계학의의（ P＜0.05）。 C조영양지지후NIHSS평분、NRS－2002평분고우A조、B조，이GCS평분저우A조화B조；이C조불량반응화병발증적발생솔위18.18％，고우A조적5.00％화B조적5.88％，차이유통계학의의（ P＜0.05）。결론뇌졸중환자장내영양채용자제균장액병진행상응적호리，가취득여상품영양액상사적효과，가개선뇌졸중환자적영양상황、인지공능，촉진환자지체능력적회복，개선환자적예후，현저제고환자적생활질량，병강저불량반응화병발증적발생솔，치득림상추엄사용。
Objective To investigate the effect of homemade nutrient grout in enteral nutrition support of patients with stroke .Methods 200 patients with moderate or severe stroke were divided into group A (n=60), group B (n=85) and group C (n=55) according to family wishes.Group A received homemade nutrient grout for enteral nutritional and nursing care .Group B received Enteral Nutrition Emul-sion in Enteral nutrition support and care .Group C received family-owned liquid diet for nutritional support and regular care .Total protein (TP), albumin(ALB), prealbumin(PA), nutritional status and nutritional risk screening (NRS-2002), quality of life, neurological function defect score ( NHISS) ,Glasgow coma scale ( GCS) , incidence of adverse reactions and complications of the 3 groups were statisti-cally analyzed.Results Total protein, white protein, nutrition indicators, life quality, NHISS and GCS of 3 groups before nursing has no statistic difference.TP, ALB, PA, NRS-2002, life quality, NHISS, GCS and adverse reaction and complication incidence of group A and group B after nursing has no statistic differences .TP, ALB and PA of C group after nursing are lower than group A and group B , and the difference is statistically significant (P<0.05).Physical functioning, general health, vitality, and other 5 dimensions of life quali-ty of Group C after nursing are lower than that of group A and group B , and the difference is statistically significant (P<0.05).NHISS and NRS-2002 of group C are higher than group A and group B , and GCS of group C is lower than group A and group B (P<0.05).Adverse reactions and complication rate of group C is 18.18%, which are higher than 5.00%and 5.88%of group A and group B (P<0.05).Con-clusion Homemade nutrient grout used in intestinal nutrition of patients with brain stroke is worthy of clinical use , because it can gain sim-ilar effect as merchandise nutrition liquid , improve nutrition status, prognosis, life quality, cognitive function and patients limb capacity of recovery, and significantly reduce bad reaction and complications occurred rate .