急性重症脑梗死患者早期肠内营养对内分泌功能的影响

目的探讨急性重症脑梗死患者早期肠内营养对内分泌功能的影响。方法选择2015年1月~2017年6月在我院诊断治疗的急性重症脑梗死患者100例为研究对象,随机分为早期营养组(早期组)与中晚期营养组(中晚期组)各50例。早期营养组在入院24~48 h内进行肠内营养,中晚期营养组患者在48 h且5 d内给予肠内营养。比较两组患者住院时间,住院期间并发症情况,记录两组患者静息时能量消耗,开始肠内营养时间,开始肠内营养的第1天、第3天及第7天能量入量,入院时、第6天及第12天TSH、FT3、FT4、皮质醇,男性患者睾酮水平。结果早期组感染并发症显著低于中晚期组,平均住院天数显著短于中晚期组,差异有统计学意义(P0.05)。第1天、第3天及第7天能量入量显著高于中晚期组,差异有统计学意义(P0.05)。第6天及第12天早期组TSH、FT3以及FT4水平均显著高于中晚期组,差异有统计学意义(P0.05)。第6天及第12天早期组皮质醇水平显著低于中晚期组,差异有统计学意义(P0.05)。结论早期肠内营养能够显著降低患者的感染并发症,缩短住院时间,提高能量入量,稳定内分泌功能,减弱TSH、FT3、FT4、皮质醇波动。

Effect of early enteral nutrition on endocrine function in the patients with acute severe cerebral infarction

Objective To investigate the effect of early enteral nutrition on endocrine function in the patients with acute severe cerebral infarction.Methods 100 patients with acute severe cerebral infarction who were diagnosed and treated in our hospital from January 2015 to June 2017 were selected as the study subjects.The patients were randomly divided into early nutrition group(early group)and middle and late nutrition group(middle and late group),with 50 cases in each group.Enteral nutrition was given within 24-48h after admission in the early nutrition group,and the middle and late nutrition group was given enteral nutrition within>48 hours and<5 days after admission.The length of stay and complications during hospitalization were compared between the two groups.The resting energy consumption,enteral nutrition start time,and energy intake on day 1,day 3 and day 7 after enteral nutrition were recorded in both groups.The levels of TSH,FT3,FT4,cortisol and testosterone upon admission,day 6 and day 12 were also recorded.Results The infection rate of complications in the early group was significantly lower than that in the middle and late group.The average length of stay were significantly shorter than that in the middle and late group.The difference was statistically significant(P<0.05).On day 1,day 3 and day 7,the amount of energy intake was significantly higher than that in the middle and late group,and the difference was statistically significant(P<0.05).The levels of TSH,FT3 and FT4 on day 6 and day 12 in the early group were significantly higher than those in the middle and late group,and the differences were statistically significant(P<0.05).On day 6 and day 12,the levels of cortisol in the early group were significantly lower than those in the middle and late group,and the differences were statistically significant(P<0.05).Conclusion Early enteral nutrition can significantly reduce the infection rate of complications in the patients,shorten the hospital stay,increase energy intake,stabilize the endocrine function and weaken the fluctuations of TSH,FT3,FT4 and cortisol.