重症脑卒中患者肠内营养混悬液营养干预的疗效观察

目的：观察重症脑卒中患者肠内营养混悬液营养干预的疗效。方法：823例重症脑卒中患者按就诊顺序分为两组。观察组423例患者采用肠内营养混悬液进行鼻饲,对照组400例患者采用家庭自制匀浆膳食进行鼻饲。两组患者均根据疾病类型选择合适的常规处理措施进行治疗。比较两组患者治疗前后的血总蛋白（ TB）、血红蛋白（ Hb）、血白蛋白（ Alb）、三酰甘油（ TG）等营养指标,以及神经功能缺损评分（ NIHSS）、Barthel指数,肌力恢复状况及治疗后的并发症。结果：两组患者的TB、Hb、Alb及TG等各项营养指标均显著下降（P〈0.05）,但观察组各项指标明显高于对照组（P〈0.05）。两组患者的NIHSS评分均明显降低（P〈0.01）,Barthel指数明显升高（P〈0.01）；但观察组患者治疗后NIHSS评分与Barthel指数均明显优于对照组（P〈0.05）。观察组肌力恢复明显高于对照组（P〈0.05）,两组患者并发症发生情况差异无统计学意义（P〉0.05）。结论：肠内营养混悬液能够有效改善重症脑卒中患者的营养状况,并发症少,安全性高,值得临床推广应用。

Efficacy of Nutritioned Intervention with Nutritional Suspensions in Patients with Severe Stroke

Objective：To observe the efficacy of enteral nutritional suspensions in the patients with severe stroke. Methods：To-tally 823 cases of severe stroke patients were divided into the observation group and the control group according to the visiting se-quence. The 423 cases in the observation group were treated with enteral nutritional suspensions, while another 400 patients in the con-trol group were given the home-made meals with nasal feeding, and relative routine treatment was given the patients according to the disease type in the two groups. Before and after the treatment, serum total protein （ TB） , hemoglobin （ HB） , serum albumin （ ALB） and TG of the two groups were recorded, neurological deficit scores （ NIHSS） , Barthel index, muscle recovery and complications were also studied and compared. Results：After the treatment, TB, HB, ALB and TG of the two groups were significantly decreased （ P〈0. 05）, while the nutritional indicators in the observation group were significantly higher than those in the control group （P〈0. 05）. After the treatment, NIHSS score of the two groups was significantly decreased （P〈0. 01）, Barthel index was significantly increased （P〈0. 01）, and those in the observation group were better than those in the control group （P〈0. 05）. The muscle recovery of the observation group was significantly higher than that of the control group （P〈0. 05）. There was no significant difference in the compli-cations between the two groups（P〉0. 05）. Conclusion： Enteral nutritional suspensions can improve the nutritional status of the pa-tients with severe stroke with fewer complications and better safety, which are worthy of clinical application.