重症脑卒中患者营养风险筛查与营养支持现状调查

目的 探讨营养风险筛查（nutritional risk screening，NRS）用于评估重症脑卒中患者营养状态的意义，比较肠内外营养支持治疗对该类患者的临床应用价值。方法 采用回顾性调查方法，对267例重症脑卒中患者根据营养风险筛查2002版[2002年欧洲肠外肠内营养学会（ESPEN）推荐的成人营养风险筛查方法，NRS 2002]进行营养评估，并根据营养支持类型分为3组，包括肠内营养（EN）组、肠外营养（PN）组和联合营养（EN+PN）组，通过比较使用前后各项指标的变化情况，对各组的临床疗效和不良反应进行评价。结果 通过比较患者入院第1天与第10天的营养状况、肝肾功能及并发症情况，发现EN组、EN+PN组相对用药前的总蛋白、白蛋白水平有显著性提高（P<0.05），且EN组肝肾功能指标变化较小，合并感染的发生率为16.67%。结论 肠内营养支持能有效改善重症脑卒中患者的营养状况，降低患者感染及胃肠道并发症的发生率，明显改善患者预后。

Nutritional risk screening and nutritional support survey of patients with severe stroke

Objective To discuss the signficance using nutrtional risk screening (NRS) to evaluate nutritional status in patients with severe stroke. In the meantime compare the clinical application value between enteral and parenteral nutritional support therapies. Methods A retrospective survey was adopted to analyze the nutritional status in 267 patients with severe stroke. Their nutritional statuses were evaluated by NRS 2002 nutrtional risk screening. Patients were divided into three groups, including enteral nutrition (EN) group, parenteral nutrition (PN) group and EN+PN group based on the type of their nutritional support. By comparing changes of indicators before and after of adiministration of nutritional support, the clinical efficacy and adverse reactions for each group were evaluated. Results In EN group and EN+PN group total protein and albumin level were significantly increased after 10 days nutritional support (P<0.05). Small changes in patients'' liver and kidney function indices in EN group. The incidence of co-infection was 16.67% in EN group, which was lowest among three groups. Conclusion Enteral nutrition support could not only improve the nutritional status of patients with severe stroke, but also could reduce the incidence of infections and gastrointestinal complications. It significantly improves the prognosis of patients.