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高龄吞咽困难卒中患者的肠内营养支持研究
引用本文:郑天衡,吴霖浦,王少石.高龄吞咽困难卒中患者的肠内营养支持研究[J].中国卒中杂志,2007,2(3):212-215.
作者姓名:郑天衡  吴霖浦  王少石
作者单位:广西省桂林市桂林市人民医院神经内科(现苏州大学附属第二医院神经病学硕士研究生)桂林市人民医院神经内科上海交通大学附属第一人民医院分院神经内科
摘    要:目的 探讨早期肠内营养支持能否改善高龄吞咽困难卒中患者的临床疗效。方法 选择急性卒中伴吞咽困难的高龄患者(年龄≥75岁)67例,研究组(n=36)于入院72 h内留置鼻饲管实施规范肠内营养,对照组(n=36)于入院1周内留置鼻饲管并由家属自行喂养饮食。观察两组第21天的实验室营养指标,包括总淋巴细胞计数、血红蛋白、血清白蛋白(Alb)和三酰甘油及低蛋白血症(Alb<35 g/L)发生率、感染并发症发生率及临床疗效。结果 住院第21天,研究组的总淋巴细胞计数、血红蛋白、血清白蛋白均显著优于对照组;低蛋白血症发生率研究组(38.9%)显著低于对照组(67.7%,P =0.018);感染发生率研究组(41.7%)显著低于对照组(71.0%,P =0.016);总有效率研究组(72.2%)显著高于对照组(48.4%,P =0.045)。结论 早期肠内营养支持能够改善高龄吞咽困难卒中患者的营养,降低感染并发症的发生率,有利于改善患者的临床疗效。

关 键 词:卒中  吞咽障碍  肠内营养  老年  
收稿时间:2007-1-26
修稿时间:2007年1月26日

Enteral Nutrition for Old-aged Dysphagic Stroke Patients
ZHENG Tian-heng,WU Lin-pu,WANG Shao-shi.Enteral Nutrition for Old-aged Dysphagic Stroke Patients[J].Chinese Journal of Stroke,2007,2(3):212-215.
Authors:ZHENG Tian-heng  WU Lin-pu  WANG Shao-shi
Abstract:Objective To discuss the clinical effects of early naso-gastric nutrition for old-aged dysphagicstroke patients.Methods Among 67 old-aged stroke patients (≥75 years)with dysphagia enrolled, 36 patients inthe intervention group received standard naso-gastric nutrition within 72 hours of admission, and31 patients in the control group received feeding supervised by family members. We observed thetotal lymphocyte count(TLC), the level of hemoglobin(Hb), albumin(Alb) and triglyceride (TG)between the two groups at 21 days. The hypoproteinemia(Alb<35 g/L), the frequency of infectivecomplications and neurological rehabilitation of the two groups were also compared.Results At 21 days, the TLC and the level of Hb, Alb in the intervention group were significantlyhigher than in the control group. Hypoproteinemia observed in the intervention group wassignificantly lower than in the control group (38.9% vs 67.7%, P =0.018), as well as the frequencyof infective complications (41.6% vs 71.0%, P =0.016). The proportion of better outcome in theintervention group was significantly higher than in the control group(72.2% vs 48.4%, P =0.045).Conclusion This study suggests that standardized naso-gastric nutrition is helpful for improvingnutritional status and clinical outcome, decreasing the frequency of infective complications in theold-aged dysphagic stroke patients.
Keywords:Stroke  Dysphagia  Enteral nutrition  Old-aged
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