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目的:评估EEN对脑卒中病人营养状态和预后的影响。方法:将48例脑卒中病人随机分为EEN组和延迟EN(DEN)组。EEN组于患病72 h内开始给予EN支持;DEN组患病72 h后、6 d内开始给予EN支持。入院第1和第14天检测两组病人的营养指标和NIHSS评分,第14天观察感染性并发症,第30天对住院病人和已出院的病人进行Rankin修订量表评分。结果:入院时,两组的营养指标和NIHSS评分均无显著性差异。入院后14d,EEN组血清ALB和PA显著高于DEN组(P<0.05);两组病人NIHSS评分较入院时均有改善,EEN组优于DEN组;EEN组病人的感染发生率明显少于DEN组(P<0.05)。入院第30天,EEN组病人的Rankin修订量表优于DEN组(P<0.05)。结论:对伴有进食障碍的脑卒中病人,EEN支持能稳定营养状态,减少感染性并发症,促进神经功能恢复,提高生活质量,改善预后。
PURPOSE: To evaluate the effect of EEN on nutritional status and prognosis in patients with stroke. Methods: 48 stroke patients were randomly divided into EEN group and delayed EN (DEN) group. The EN group began to receive EN support within 72 hours of onset of illness. After 72 hours of illness, the EN group began to receive EN support within 6 days. Nutritional indices and NIHSS scores were measured on the first and the fourteenth day on admission, infectious complications were observed on the 14th day, Rankin revised scale was scored on the 30th day for inpatients and discharged patients. Results: At admission, there was no significant difference in nutritional indicators and NIHSS scores between the two groups. At 14 days after admission, serum ALB and PA in EEN group were significantly higher than those in DEN group (P <0.05); NIHSS scores in both groups were improved as compared with those on admission, while EEN group was better than DEN group. The incidence of infection in EEN group was significantly less than that in DEN group DEN group (P <0.05). On the 30th day after admission, the Rankin revised scale was better in the EEN group than in the DEN group (P <0.05). CONCLUSIONS: EEN support stabilizes nutritional status, reduces infectious complications, promotes neurological recovery, improves quality of life, and improves prognosis in stroke patients with eating disorders.