中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
10期
899-903
,共5页
廖圣芳%王玉差%陈汉民%张义王%吴国鑫
廖聖芳%王玉差%陳漢民%張義王%吳國鑫
료골방%왕옥차%진한민%장의왕%오국흠
颅内出血,高血压性%胃瘫%胃肠外营养%鼻空肠管营养%鼻胃管减压
顱內齣血,高血壓性%胃癱%胃腸外營養%鼻空腸管營養%鼻胃管減壓
로내출혈,고혈압성%위탄%위장외영양%비공장관영양%비위관감압
Intracranial hemorrhage,hypertensive%Gastroparesis%Enteral nutrition%Nasojejunal nutrition%Nasogastric decompression
目的 探讨鼻空肠管营养加鼻胃管减压在重症高血压脑出血并胃瘫患者中的应用效果.方法 将2011年1月至2014年6月入院的56例重症高血压脑出血并胃瘫患者作为研究组,将2007年1月至2010年12月入院的同类患者52例作为对照组.研究组患者于确诊并发胃瘫后采用鼻空肠管营养加鼻胃管减压方式;对照组常规先采用鼻胃管营养方式,15 d后仍不能耐受肠内营养者改为肠外营养治疗.观察两组患者体质量、血清白蛋白、前白蛋白及血红蛋白等营养指标以及并发症的发生情况.病后3个月时按日常生活能力(ADL)分级法评定预后,将Ⅰ～Ⅲ级归为预后良好,Ⅳ、Ⅴ级及死亡归为预后不良.结果 治疗前两组体质量差异无统计学意义,4周后研究组与对照组平均体质量比较差异有统计学意义[(57.2±5.3)kg与(52.8±4.9)kg;t=4.33,P＜0.01)];入院后3、4周研究组的血清白蛋白分别为(34.5±3.3)、(37.8±3.8) g/L,前白蛋白为(202.3±16.7)、(216.9±17.1)g/L,血红蛋白为(119.4±12.1)、(126.2±12.8)g/L,对照组血清白蛋白分别为(30.7±3.1)、(34.1±3.4) g/L,前白蛋白为(179.6±15.2)、(203.1±15.4) g/L,血红蛋白为(107.7±11.3)、(113.5±11.9) g/L,研究组营养状态明显优于对照组(t值分别为6.16、5.32、7.37、4.85、5.18、5.32,P均＜0.01);而并发症明显少于对照组(P均＜0.05);3个月后研究组预后良好率为80.36％ (45/56),对照组为61.54％ (32/52),差异有统计学意义(x2 =4.67,P＜0.05).结论 对于重症高血压脑出血并胃瘫患者采用鼻空肠管营养加鼻胃管减压方式,可有效改善患者的营养状态,增强机体抵抗力,降低并发症发生率,明显改善预后.
目的 探討鼻空腸管營養加鼻胃管減壓在重癥高血壓腦齣血併胃癱患者中的應用效果.方法 將2011年1月至2014年6月入院的56例重癥高血壓腦齣血併胃癱患者作為研究組,將2007年1月至2010年12月入院的同類患者52例作為對照組.研究組患者于確診併髮胃癱後採用鼻空腸管營養加鼻胃管減壓方式;對照組常規先採用鼻胃管營養方式,15 d後仍不能耐受腸內營養者改為腸外營養治療.觀察兩組患者體質量、血清白蛋白、前白蛋白及血紅蛋白等營養指標以及併髮癥的髮生情況.病後3箇月時按日常生活能力(ADL)分級法評定預後,將Ⅰ～Ⅲ級歸為預後良好,Ⅳ、Ⅴ級及死亡歸為預後不良.結果 治療前兩組體質量差異無統計學意義,4週後研究組與對照組平均體質量比較差異有統計學意義[(57.2±5.3)kg與(52.8±4.9)kg;t=4.33,P＜0.01)];入院後3、4週研究組的血清白蛋白分彆為(34.5±3.3)、(37.8±3.8) g/L,前白蛋白為(202.3±16.7)、(216.9±17.1)g/L,血紅蛋白為(119.4±12.1)、(126.2±12.8)g/L,對照組血清白蛋白分彆為(30.7±3.1)、(34.1±3.4) g/L,前白蛋白為(179.6±15.2)、(203.1±15.4) g/L,血紅蛋白為(107.7±11.3)、(113.5±11.9) g/L,研究組營養狀態明顯優于對照組(t值分彆為6.16、5.32、7.37、4.85、5.18、5.32,P均＜0.01);而併髮癥明顯少于對照組(P均＜0.05);3箇月後研究組預後良好率為80.36％ (45/56),對照組為61.54％ (32/52),差異有統計學意義(x2 =4.67,P＜0.05).結論 對于重癥高血壓腦齣血併胃癱患者採用鼻空腸管營養加鼻胃管減壓方式,可有效改善患者的營養狀態,增彊機體牴抗力,降低併髮癥髮生率,明顯改善預後.
목적 탐토비공장관영양가비위관감압재중증고혈압뇌출혈병위탄환자중적응용효과.방법 장2011년1월지2014년6월입원적56례중증고혈압뇌출혈병위탄환자작위연구조,장2007년1월지2010년12월입원적동류환자52례작위대조조.연구조환자우학진병발위탄후채용비공장관영양가비위관감압방식;대조조상규선채용비위관영양방식,15 d후잉불능내수장내영양자개위장외영양치료.관찰량조환자체질량、혈청백단백、전백단백급혈홍단백등영양지표이급병발증적발생정황.병후3개월시안일상생활능력(ADL)분급법평정예후,장Ⅰ～Ⅲ급귀위예후량호,Ⅳ、Ⅴ급급사망귀위예후불량.결과 치료전량조체질량차이무통계학의의,4주후연구조여대조조평균체질량비교차이유통계학의의[(57.2±5.3)kg여(52.8±4.9)kg;t=4.33,P＜0.01)];입원후3、4주연구조적혈청백단백분별위(34.5±3.3)、(37.8±3.8) g/L,전백단백위(202.3±16.7)、(216.9±17.1)g/L,혈홍단백위(119.4±12.1)、(126.2±12.8)g/L,대조조혈청백단백분별위(30.7±3.1)、(34.1±3.4) g/L,전백단백위(179.6±15.2)、(203.1±15.4) g/L,혈홍단백위(107.7±11.3)、(113.5±11.9) g/L,연구조영양상태명현우우대조조(t치분별위6.16、5.32、7.37、4.85、5.18、5.32,P균＜0.01);이병발증명현소우대조조(P균＜0.05);3개월후연구조예후량호솔위80.36％ (45/56),대조조위61.54％ (32/52),차이유통계학의의(x2 =4.67,P＜0.05).결론 대우중증고혈압뇌출혈병위탄환자채용비공장관영양가비위관감압방식,가유효개선환자적영양상태,증강궤체저항력,강저병발증발생솔,명현개선예후.
Objective To investigate the effects of nasojejunal feeding plus nasogastric tube decompression in severe hypertensive intracerebral hemorrhage complicated with gastroparesis.Methods Fifty-six cases of severe hypertensive intracerebral hemorrhage complicated with gastroparesis admitted to hospital from January 2011 to June 2014 were chosen as study group, while the 52 cases of similar patients admitted to hospital from January 2007 to December 2010 were chosen as control group.Nasojejunal feeding and nasogastric tube decompression were given to the study group.Nasogastric enteral nutrition support therapy was firstly given to the control group conventionally,after 15 days if they still could to be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight, serum albumin, prealbumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.The patients were followed up according to activity of daily liying(ADL) after 3 months.Results There was no significant difference on the average body weigh between two groups before treatment.The average body weight of the study group was significantly higher than that of the control group after 4 weeks treatment((57.2±5.3) kg vs.(52.8±4.9) kg,t=4.33,P＜0.01).The serum albumin, pre albumin and hemoglobin of 3 week, four week after treatment were significantly higher than those of the control group(serum albumin of 3 week: (34.5±3.3) g/L vs.(30.7±3.1) g/L;erum albumin of four week:(37.8±3.8) g/L vs.(34.1 ± 3.4) g/L;serum prealbumin of 3 week:(202.3± 16.7) g/L vs.(179.6 ±15.2) g/L;serum prealbumin of four week: (216.9±17.1) g/L vs.(203.1±15.4) g/L;hemoglobin of 3 week : (119.4± 12.1) g/L vs.(107.7 ± 11.3) g/L;hemoglobin of four week : (126.2± 12.8) g/L vs.(113.5 ±11.9) g/L).Nutritional status of study group was significantly better than that of the control group(t=6.16, 5.32,7.37,4.85,5.18,5.32;P＜0.01), and complications was significantly less than that of the control group (P＜0.05).After three months, the good prognosis rate of study group (80.36％ (45/56)) was significantly higher than that of the control group (6 1.54％ (32/52)), the difference was statistically significant (x2 =4.67, P ＜0.05).Conclusion Nasojejunal feeding plus nasogastric tube decompression for patients with severe hypertensive intracerebral hemorrhage with gastroparesis can improve nutritional status, enhance their body resistance, reduce the incidence of complications, and improve their prognosis.
