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1.
目的评价早期肠内营养支持对危重症脑卒中患者营养状况和并发症的影响。方法将117例重症脑卒中患者采用信封随机法分为试验组63例,对照组54例。试验组采用早期肠内营养支持,对照组发病10d后给予肠内营养。比较干预前后2组的营养状况(包括血清白蛋白、血清前白蛋白及维生素C含量)、并发症如肺部感染、腹泻及便秘的发生率。结果干预后试验组营养状况,如血清白蛋白、血清前白蛋白及维生素C含量高于对照组(P0.05),并发症如肺部感染、腹泻及便秘的发生率低于对照组(P0.05)。结论早期肠内营养支持可改善危重症脑卒中患者的营养状况,降低并发症发生率,值得临床推广使用。  相似文献   

2.
肠内肠外复合营养对重型颅脑损伤患者预后的影响   总被引:6,自引:0,他引:6  
目的探讨重型颅脑损伤肠内肠外复合营养支持的临床意义及对预后的影响。方法选择重型颅脑损伤40例,随机分为治疗组20例和对照组20例。治疗组采用肠内肠外复合营养,对照组常规治疗。观察治疗后病人的前白蛋白、血糖、血红蛋白、血清白蛋白、淋巴细胞计数、并发症发生率及预后。结果治疗组病例营养状态明显好于对照组(P<0.01),并发症减少,预后良好。结论重型颅脑损伤病人早期肠内肠外复合营养支持有利于颅脑损伤病人尽早恢复。  相似文献   

3.
目的探讨早期肠内营养对重症脑卒中患者营养状况及并发症的影响。方法选取2015-05—2016-06我科收治的96例重症脑卒中患者为研究对象,随机分为观察组50例和对照组46例,2组均给予脱水降颅压、营养神经、脑保护、保护胃黏膜等常规治疗,观察组在常规基础上早期(24~48h)给予肠内营养治疗,对照组在常规治疗基础上给予肠外营养治疗,观察2组治疗前后营养指标变化情况,比较2组并发症发生率。结果治疗2周后,2组前白蛋白、白蛋白、血红蛋白均较治疗前下降,但对照组下降更为明显,2组比较差异均有统计学意义(P0.05),治疗后观察组感染、腹泻或腹胀便秘、电解质紊乱等并发症发生率为22%,明显低于对照组41.3%,差异有统计学意义(P0.05)。结论早期肠内营养能更好改善重症脑卒中的营养状况,减少并发症发生率。  相似文献   

4.
目的探讨重型颅脑损伤患者超早期营养支持治疗的效果。方法将67例重型颅脑损伤病人按营养支持治疗方法分为观察组(n=35)和常规组(n=32)。常规组入院24 h后进行营养支持,观察组入院即进行营养评估及支持(超早期),并加用肠粘膜保护剂。入院后第1、3、7、10、14及21天观察两组间营养指标血清白蛋白、肺部感染率、肺部感染持续时间、腹胀、消化道出血及GCS评分。结果观察组血清白蛋白水平明显高于常规组(P0.05)。两组患者伤后并发症(肺部感染、腹胀、消化道出血)发生率无明显差异(P0.05),但是观察组肺部感染持续时间明显缩短(P0.05)。治疗后10~14 d,观察组GCS评分较常规组明显增高(P0.05)。结论超早期营养支持并未增加肠内营养相关并发症,可以改善重型颅脑损伤病人营养状况、缩短肺部感染时间,促进病人康复。  相似文献   

5.
目的分析神经危重症患者发生胃潴留的相关因素及营养支持对预后的影响。方法选择自2012年7月2013年2月在吉林大学白求恩第一临床医学院神经内科重症监护室住院患者共73例,根据残留量是否超过200ml,分为胃潴留组和非胃潴留组,胃潴留组给予肠内、肠外联合营养支持,非胃潴留组给予全肠内营养支持。结果神经危重症患者入院时的GCS评分越低,发生胃潴留可能性越大(P<0.05);发病1w之内发生胃潴留的人数最多,达68%;营养支持治疗1w、3w时两组间比较血清白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白、血红蛋白水平均无明显差异(P>0.05);营养支持治疗3w后非胃潴留组患者的IgG、IgA水平高于胃潴留组患者(P<0.05)。结论神经危重症患者入院时的GCS评分与胃潴留的发生关系最为密切;在发病1w内胃潴留发生率最高;对于有胃潴留的患者行肠内、肠外联合营养可以获得与完全肠内营养支持相似的疗效;完全肠内营养还可改善神经危重症患者的免疫功能。  相似文献   

6.
目的探讨早期肠内营养在重型颅脑损伤去骨瓣减压术后患者中的应用。方法对我院2013年1月至2014年6月57例重型颅脑外伤去骨瓣减压术后患者分为肠内营养组和肠外营养组,分别对两组患者的治疗7天后白蛋白及前白蛋白水平、重症监护室(intensive care unit,ICU)内感染并发症及28天死亡率的比较。结果早期肠内营养组中急性胃肠损伤(Acute gastrointestinal injury,AGI)分级Ⅰ级-Ⅱ级患者治疗7天后的前白蛋白水平较高(t=2.37,P=0.025,具有统计学意义),ICU感染并发症较少(χ2=7.636,P=0.06,具有统计学意义),28天死亡率低(χ2值4.667,P=0.031,具有统计学意义)。结论重型颅脑损伤开颅去骨瓣减压术后患者根据急性胃肠损伤分级,胃肠功能AGIⅠ级-Ⅱ级患者应尽早启动肠内营养。  相似文献   

7.
目的探讨早期肠内营养支持在重型颅脑损伤患者中的应用效果。方法 108例重型颅脑损伤患者随机分为观察组与对照组每组54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2组患者治疗效果。结果经治疗,观察组血清白蛋白、血清总蛋白、血红蛋白等营养指标以及GCS评分均显著升高(P<0.01),且治疗后观察组显著优于对照组(P<0.01);治疗期间观察组胃肠道并发症发生率35.2%,显著低于对照组的55.6%(P<0.05)。结论早期肠内营养支持可有效改善重型颅脑损伤患者全身营养状态,增强机体免疫功能,减少治疗期间各种并发症的发生,值得推广。  相似文献   

8.
目的探讨早期肠内营养对大面积脑梗死患者预后的影响。方法选择2015-06—2016-06南阳市中心医院收治的大面积脑梗死患者86例,随机分为对照组(43例)和观察组(43例),对照组患者给予传统鼻饲营养支持,观察组患者给予早期肠内营养支持,对比2组患者营养状况、胃肠功能情况、日常活动功能状况、神经功能状况以及并发症发生情况。结果治疗后,2组患者营养学各指标均有所改善,且观察组明显优于对照组(P0.05);观察组胃肠功能紊乱发生情况明显少于对照组(P0.05);治疗后,2组患者BI评分和NIHSS评分均有所改善,且观察组明显优于对照组(P0.05);相对于对照组,观察组并发症发生情况明显减少(P0.05)。结论早期肠内营养应用于大面积脑梗死患者治疗中,可有效纠正患者代谢紊乱状况,使机体免疫力得到有效提升,并促进患者神经功能恢复,明显减少并发症,对于改善患者预后具有积极意义。  相似文献   

9.
目的观察早期肠内给予益生菌联合肠外丙氨酰谷氨酰胺对重症外伤并颅脑损伤患者肠道功能恢复的疗效。方法回顾性分析2011-03—2016-03因外伤入住重症医学科的多脏器功能障碍患者218例,随机分为对照组和治疗组,比较2组治疗3周后的营养状况、生化指标及治疗效果。结果治疗组治疗3周后营养状况、生化指标及治疗效果均优于对照组。结论早期给予肠内营养辅以含4种益生菌酸牛奶联合肠外应用丙氨酰谷氨酰胺,可更好地促进胃肠功能的恢复,改善患者的营养状况,减少并发症的发生率,改善预后。  相似文献   

10.
重症老年脑卒中患者营养状况与营养支持   总被引:2,自引:0,他引:2  
目的 分析收住NICU重症老年脑卒中患者的蛋白代谢、血脂代谢、免疫功能变化与并发症的发生,探讨营养状况、营养支持与疾病预后的相关性.方法 选择30例收住NICU的重症老年脑卒中患者,检测入院第1天、第14天血红蛋白、血清总蛋白、白蛋白、前白蛋白、总胆固醇、甘油三酯、IgA、IgM、IgG的含量.分析第1天、第14天血红蛋白、蛋白代谢、脂代谢及部分血清免疫的变化.比较并发感染组(n=20)和非感染组(n=10)的第1天、第14天血清白蛋白、血红蛋白的水平.分析营养支持前后并发症.结果 重症老年脑卒中患者住院14天后血红蛋白、前白蛋白、白蛋白、甘油三酯、总胆固醇、IgG水平均有明显下降(P<0.05),合并感染率达67%,死亡率7%.第1天、14天感染组及非感染组血清白蛋白、血红蛋白的水平下降,组间无显著差异(P>0.05).结论 重症老年脑卒中后营养状况呈恶化趋势,以2周内白蛋白和血红蛋白的下降最为明显.营养状况的恶化,延缓脑卒中患者的神经功能康复,增加合并症发生和住院成本.肠内营养治疗虽可延缓营养状况的恶化,但老年患者卒中后神经内分泌代谢改变、营养成分消化吸收摄入能力下降与高消耗等多因素阻碍营养障碍改善,寻找更加符合老年重症患者吸收的营养支持,包括营养制剂、营养途径与方法,有益于改善老年重症卒中患者营养状况,降低住院成本,提高生存质量.  相似文献   

11.
Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005  相似文献   

12.
BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.  相似文献   

13.
2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。  相似文献   

14.
目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。  相似文献   

15.
《Clinical neurophysiology》2020,131(1):243-258
Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.  相似文献   

16.
目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。  相似文献   

17.
18.
Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.  相似文献   

19.
Introduction: An important consideration in treating acute mania is the promptness with which a chosen therapy can bring symptom amelioration. This article reviews the available published data from controlled, blinded studies regarding the latency of responses to antipsychotics in patients with acute mania.

Methods: Articles for this review were obtained from a search of the Medline database (1966–1999), using the following keywords and phrases: antipsychotic, atypical, bipolar disorder, mania, neuroleptic, typical. The bibliographic sections of articles gleaned from this search were used to direct further inquiries.

Results: Although information regarding the onset of action of antipsychotics is limited, we discovered data for four typical and three atypical antipsychotics. Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2–6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer. Data regarding pimozide are mixed, with some studies showing an onset equivalent to that of the 'fast' compounds and others showing one similar to that of the 'slow' compounds.

Conclusions: Choice of therapy should consider not only efficacy and safety, but also onset speed. Atypical antipsychotics appear to offer safer, faster, and more effective therapies.  相似文献   

20.
Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.  相似文献   

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