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目的:研究早期肠内营养(EEN)支持治疗对急性脑干梗死病人营养指标和预后的影响。方法:将64例伴有吞咽障碍的脑干梗死病人随机分为治疗组(n=34)和对照组(n=30)。入院后24～72 h内,治疗组病人给予鼻饲肠内营养(瑞先)支持,对照组病人给予普通鼻饲饮食。比较两组病人治疗前、治疗第14天营养指标的变化、神经功能评分(NIHSS评分)和并发症的发生率。结果:治疗组病人治疗14 d后,血清清蛋白(ALB)和前清蛋白(PA)无明显降低,与治疗前比无显著性差异(P≥0.05);而对照组治疗14 d后,ALB和PA均较入院前降低(P<0.05)。治疗14 d后,治疗组ALB和PA均高于对照组,两组间比较,差异有显著性统计学意义(P<0.05)。治疗组病人上消化道出血和肺部感染的发生率均显著低于对照组(P<0.05),NIHSS评分显著优于对照组(P<0.05)。结论:早期合理EN支持,可减轻重症脑干梗死病人的营养状况恶化程度,减少并发症,改善预后。
Objective: To study the effect of early enteral nutrition (EEN) supportive therapy on nutritional indicators and prognosis in patients with acute brain stem infarction. Methods: A total of 64 patients with brain stem infarction with dysphagia were randomly divided into treatment group (n = 34) and control group (n = 30). Within 24 to 72 h after admission, patients in the treatment group were given nasogastric enteral nutrition (Ruixian) support, and patients in the control group were given normal nasal feeding. The changes of nutritional indexes, neurological function score (NIHSS score) and the incidence of complications before treatment and on the 14th day of treatment were compared between the two groups. Results: Serum albumin (ALB) and prealbumin (PA) had no significant difference between the treatment group and the control group before 14 days of treatment (P> 0.05) And PA were lower than before admission (P <0.05). After 14 days of treatment, ALB and PA in the treatment group were significantly higher than those in the control group. There was significant difference between the two groups (P <0.05). The incidence of upper gastrointestinal bleeding and pulmonary infection in the treatment group was significantly lower than that in the control group (P <0.05), and the NIHSS score was significantly better than that in the control group (P <0.05). Conclusion: Early reasonable EN support can reduce the deterioration of nutritional status in patients with severe brain stem infarction, reduce complications and improve prognosis.