不同营养支持治疗对老龄重症脑血管病患者营养状况的影响及疗效观察

目的:观察不同营养支持方式对老龄重症脑血管疾病患者的营养状况影响及临床疗效。方法:老年重症脑血管病患者66例,随机分为肠内营养组(EN)与肠外营养组(PN),各33例,两组常规治疗相同,按照等氮、等热量的营养支持原则,EN组逐步实施肠内营养,PN组给予肠外营养。2周后观察体重变化百分比(IBW%)、肱三头肌皮褶厚度(TSF)、血清白蛋白、血红蛋白变化,记录治疗期间并发症发生情况及3个月后临床疗效。结果:两组病例治疗后TSF、血清白蛋白、血红蛋白与治疗前明显下降,差异有统计学意义;治疗后EN组IBW%、TSF、血清白蛋白、血红蛋白优于PN组,差异有统计学意义。EN组上消化道出血及肺部感染发生率均少于对照组,差异有统计学意义。PN组总有效率为66.7%,EN组总有效率为42.4%,PN组病死率为18.2%,EN组病死率为42.4%,差异有统计学意义。结论:肠内营养在改善老龄重症脑血管病患者营养状况、减少并发症及远期的病死率方面优于肠外营养,值得临床推广。

The effects of different nutritional support on nutritional state of patients with severe cerebrovascular disease

Objective：To investigate different nutritional supportthe effects of on the nutritional state of patients with severe cerebrovascular disease . Methods： Sixty-six patients suffered with severe cerebrovascular disease were randomly divided into 2 groups：early enteral nutrition group （EN）and early total parenteral nutrition group （TPN）. The same amount of energy and nitrogen was given to the two groups, the two groups were compared on IBW~ ,TSF,SAP,Hb, incidence rate of complications and therapeutic effects. Results ：IBW ~,TSF, SAP,Hb of both group were decreased significantly after 14 days. IBW ~, TSF,SAP,Hb of EN group were superior to those in PN. The incidence of upper gastrointestinal bleeding and pulmonary infection was less than that in PN group. Total effective rate and death rate were superior to those in PN. Conclusions ：Early enteral nutrition could improve nutritional state and increase total effective rate and decrease incidence of complications and death rate.