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目的:探讨早期肠内营养(EEN)支持对高分级动脉瘤性蛛网膜下腔出血病人营养指标、炎性因子及预后的影响。方法:将76例高分级动脉瘤性蛛网膜下腔出血病人随机分为EEN组和对照组。EEN组病人在入院24 h后给予EN支持;对照组在入院第5~7天后给予EN支持。比较两组病人治疗前后营养指标[血清清蛋白(ALB)、总蛋白(TP)、血红蛋白(Hb)、肱三头肌皮皱厚度(TSF)和上臂肌围(AMC)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]和意识恢复程度的变化。结果:EEN组病人在治疗第7和14天各营养指标水平明显优于对照组(P<0.05),炎性因子含量较对照组显著降低(P<0.05),而意识恢复程度(通过GCS评分)好于对照组(P<0.05)。结论:EEN可有效地改善高分级动脉瘤性蛛网膜下腔出血病人的营养状况,降低炎性因子水平,有利于病人康复。
Objective: To investigate the effect of early enteral nutrition (EEN) support on nutritional parameters, inflammatory factors and prognosis in patients with high-grade aneurysmal subarachnoid hemorrhage. Methods: 76 patients with high-grade aneurysmal subarachnoid hemorrhage were randomly divided into EEN group and control group. Patients in the EEN group were given EN support 24 h after admission. Patients in the control group were enrolled EN after admission on days 5 to 7. The nutritional indexes (ALB, total protein (TP), hemoglobin (Hb), triceps skin fold thickness (TSF) and upper arm muscle circumference (AMC) Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and the degree of consciousness recovery. Results: The levels of nutritional indicators in the EEN group were significantly better than those in the control group on the 7th and 14th days (P <0.05), while the levels of inflammatory factors in the EEN group were significantly lower than those in the control group (P <0.05) ) Better than the control group (P <0.05). Conclusion: EEN can effectively improve the nutritional status of patients with high-grade aneurysmal subarachnoid hemorrhage and reduce the level of inflammatory cytokines, which is good for patient’s recovery.