CAJ | 학술논문

目的：探讨不同的鼻饲方法对急性脑卒中合并吞咽障碍患者的临床应用效果。方法选择急性脑卒中合并吞咽障碍患者80例，随机分为对照组和观察组各40例。两组均采用瑞代肠内营养乳剂，对照组采用手工分次分量推注鼻饲喂养方法，观察组采用恒温点滴间断滴注的方法。观察两组的营养、炎症指标的变化以及并发症的发生率。结果对照组治疗3周后，血清白蛋白、前白蛋白、血尿素氮、血肌酐较治疗前明显下降（P ＜0．05），炎性指标CRP明显高于治疗前（P ＜0．01）；观察组治疗3周后，血清白蛋白、前白蛋白明显高于治疗前（P ＜0．01），而血尿素氮、血肌酐无明显变化（P ＞0.05），CRP水平高于治疗前（P ＜0．01）；治疗3周末，对照组血白蛋白、前白蛋白、血尿素氮、血肌酐明显低于观察组（P＜0．01），而CRP明显高于观察组（P＜0．05）。观察组呕吐返流、误吸、肺部感染的发生率明显低于对照组（P ＜0．05）。结论对于急性脑卒中合并吞咽障碍患者，采用恒温点滴间断滴注的鼻饲方法，能有效保证营养供给和减少并发症的发生率。
목적：탐토불동적비사방법대급성뇌졸중합병탄인장애환자적림상응용효과。방법선택급성뇌졸중합병탄인장애환자80례，수궤분위대조조화관찰조각40례。량조균채용서대장내영양유제，대조조채용수공분차분량추주비사위양방법，관찰조채용항온점적간단적주적방법。관찰량조적영양、염증지표적변화이급병발증적발생솔。결과대조조치료3주후，혈청백단백、전백단백、혈뇨소담、혈기항교치료전명현하강（P ＜0．05），염성지표CRP명현고우치료전（P ＜0．01）；관찰조치료3주후，혈청백단백、전백단백명현고우치료전（P ＜0．01），이혈뇨소담、혈기항무명현변화（P ＞0.05），CRP수평고우치료전（P ＜0．01）；치료3주말，대조조혈백단백、전백단백、혈뇨소담、혈기항명현저우관찰조（P＜0．01），이CRP명현고우관찰조（P＜0．05）。관찰조구토반류、오흡、폐부감염적발생솔명현저우대조조（P ＜0．05）。결론대우급성뇌졸중합병탄인장애환자，채용항온점적간단적주적비사방법，능유효보증영양공급화감소병발증적발생솔。
Objective To observe the clinical effect of two kinds of nasal feeding in acute stroke patients with dysphagia .Methods Eight patients of acute stroke with dysphagia were randomly divided into the observation group and the control group ,with 40 cases in each group .Two groups all used enter‐al nutrition emulsion named Ruidai .The patients in the control group used manual fractional component pushed nasal feeding ,While the patients in the observation group used constant temperature drops contin‐uously drip nasal feeding .Observe the change of the two groups of nutrition ,inflammation ,and the inci‐dence of complications .Results After the treatment of the control group for 3 weeks ,serum albumin , prealbumin ,blood urea nitrogen ,serum creatinine were obviously descended than before treatment (P<0 .05) ,CRP was significantly higher than the before treatment (P < 0 .01);After the treatment of the observation group for 3 weeks ,serum albumin ,prealbumin was significantly higher than before treat‐ment (P< 0 .01) ,the blood urea nitrogen and serum creatinine were almost the same (P> 0 .05) .After the treatment of the observation group and the control group for 3 weeks ,the control serum albumin , prealbumin , blood urea nitrogen , serum creatinine were significantly lower than the observation group (P < 0 .01) ,CRP was significantly higher than the observation group (P< 0 .05) .The incidence of vomiting ,regurgitation ,aspiration ,pulmonary infection in the observation group were significantly lower than that of the observation group (P < 0 .05) .Conclusions For the acute stroke patients with dysphagia ,using constant temperature drops continuously drip nasal feeding method can effectively guar‐antee the nutrition supply and reduce the incidence of complications .