急性脑卒中早期使用胃肠内营养乳剂防治低蛋白血症的探讨

目的探讨急性脑卒中患者早期（卒中后48h～3周）使用胃肠内营养乳剂进行胃肠内营养支持对降低低蛋白血症发生的临床效果。方法选69例需肠内营养支持的急性脑卒中患者以随机对照的方法分为实验组和对照组，于卒中后48h内分别开始给予胃肠内营养乳剂（能全力）和自制匀浆膳胃管内注入进行营养支持，治疗持续时间均为21d，观察两组患者血清白蛋白（albumin，ALB）和总蛋白（total protein，TP）的动态变化。结果低蛋白血症实验组发生率14．3％，对照组发生率38．3%，实验组明显低于对照组（Х^2=5．13，P〈0．05），ALB实验组为（36．87±5．47）g／L，对照组为（33．41±5．26）g／L，TP实验组为（67．12±8．27）g／L，对照组为（63．67±9．16）g／L，实验组明显高于对照组（P〈0．05）。实验组对预防和降低低蛋白血症的发生效果明显，与对照组相比可显著降低低蛋白血症的发生。结论胃肠内营养乳剂早期应用对减少急性脑卒中后继发低蛋白血症效果明显。

Clinical Efficacy of Early Enteral Nutrition Support to reduce hypoproteinemia in Patients with Acute Stroke

Objective To investigate the clinical efficacy of early enteral nutrition support to reduce hypoproteinemia in patients with acute stroke between 48 hours and 3 weeks. Methods Sixty-nine patients with acute stroke were divided into two groups. Experimental group was given full enteral nutritional support, and control group was given homemade blenderized diet after stroke of 48 hours. The changes of albumin （ALB） and total protein （TP） contents in serum were assessed after treatment of 21 days. Results The incidence rate of hypoproteinemia of experimental and control groups were 14. 3% and 38. 3% respectively. Significant difference was found between the two groups （Х^2 = 5.13, P〈 0. 05）. The TP contents of experimental group and control group were （36. 87 ± 5.47）g/L and （33. 41±5.26）g/L. The ALB contents of experimental group and control group were （67. 12 ± 8. 27）g/L and （63. 67 ±9. 16）g/L. ALB and TP contents in experimental group were significantly higher compared with control group（P〈0. 05）. The hypoproteinemia level was markedly elevated in experimental group compared with the control group. Conclusion Early enteral nutrition support has significant clinical efficacy to reduce hypoproteinemia in patients with acute stroke.