早期肠内营养对重症神经内科疾病患者肺内感染发生率的影响

目的 探讨早期肠内营养对重症神经内科疾病患者肺内感染发生率的影响.方法 选取格拉斯哥昏迷评分（5～8分）的脑卒中患者220例,随机分为2组.对照组实施常规治疗,观察组在对照组基础上给予早期肠内营养.对2组患者肺内感染发生情况、呼吸机使用情况以及预后进行统计,并于患者出院前采用生活质量量表对2组患者生活质量进行评价.结果 观察组肺内感染率、肺内二重感染发生率、呼吸机使用率和肺内感染病死率分别为30.91%、12.73%、35.45%和8.18%,对照组分别为47.27%、27.27%、48.18%和18.18%,观察组发生率均明显低于对照组,观察组肺内感染持续时间和呼吸机使用时间分别为（6.35±2.28）d、（6.54±0.52）d,对照组分别为（15.72±2.55）d、（11.51±0.38）d,观察组明显短于对照组;观察组患者生活质量量表各因子得分均明显低于对照组.上述比较2组差异有统计学意义（P＜0.05）.结论 以脑卒中为代表的重症神经内科疾病患者实施早期肠内营养可以有效降低肺内感染发生率,改善预后,提高患者生活质量.

The effect of early enteral nutrition on incidence of clinical pulmonary infection in patients with severe neurological disease

Objective To investigate the effect of early enteral nutrition on incidence of clinical pulmonary infection in patients with severe neurological disease. Methods 220 patients with stroke and Glasgow coma score 5~8 were randomly divided into two groups. Routine treatment was given to the control group, while the control group was given early enteral nutrition on the basis of routine treatment. The incidence of lung infections, ventilator usage and outcomes of two groups were evaluated, and quality of life questionnaire before discharge were used to evaluate the quality of life of two groups. Results The rate of lung infection, pulmonary superinfection , ventilator usage and mortality were 30.91%, 12.73%, 35.45% and 8.18% respectively ,while those in the control group were 47.27%, 27.27% , 48.18% and 18.18% respectively ,and those in the observation group were significantly lower than those in the control group. The duration time of lung infections and ventilator use in the observation group was （6.35±2.28） d and （6.54±0.52） d respectively, and were significantly shorter than those in the control group[（15.72±2.55） d and （11.51±0.38） d]. All factors scores of quality of life scale in the observation group were significantly lower than those in the control group. All the difference between the two groups was statistically significant （P〈0.05）. Conclusion Early enteral nutrition can effectively reduce the incidence of lung infections and improve outcomes and quality of life of patients with severe neurological disease as the representative of stroke .