序贯肠内营养对老年重症脑卒中患者营养代谢、免疫功能及预后的影响

目的:探讨序贯肠内营养对老年重症脑卒中患者营养代谢、免疫功能和预后的影响。方法:将90例老年重症脑卒中患者随机分为序贯肠内营养组30例、肠内营养组30例和对照组30例予以营养支持。入院第1天和第14天分别检测患者营养指标、免疫功能指标、格拉斯哥昏迷评分(GCS)、美国国立卫生院神经功能缺损评分(NIHSS);统计3组患者住院期间并发症发生率。结果:治疗14天后3组各项指标均较第1天明显下降,对照组较序贯肠内营养组和肠内营养组下降更明显;与对照组相比较,治疗14天后序贯肠内营养组和肠内营养组TLC、IgA,IgM,IgG水平明显升高;GCS评分明显升高,NIHSS评分明显降低;序贯肠内营养组、肠内营养组各项并发症较对照组发生率低。结论:老年重症脑卒中患者随病程延长,营养状况呈恶化趋势。肠内营养可改善患者营养状况,改善机体免疫功能,降低并发症发生率,改善预后。序贯肠内营养较肠内营养效果更佳。

Effect of Sequential Enteral Nutrition on Nutritional Metabolism, ImmuneFunction and Prognosis in Eldly Patients with Severe Stroke

Objective:To investigate the effect of sequential enteral nutritional support on nutritional metabolism, immunefunction and prognosis in elderly patients with severe stroke.Methods:Ninety elderly patients with severe stroke were selected andrandomly divided into three groups: SEN(sequential enteral nutrition) group, EN (enteral nutrition) group and the control group who weregiven normal liquid diet. To count the complication rates, indicators related to nutrition and immune were tested, and Glasgow comascore (GCS)and National Institutes of Health Stroke Scale (NIHSS) were also used at the 1st day and 14th day of hospitalization.Results:The nutritional index decreased at the 14th day after admission in all the three groups, and there was a more significant decrease in thecontrol group ( P < 0. 05). Compared with the control group, after 14-day nutrition support, the levels of the blood total lymphocyte count(TLC), IgA, IgMand IgG in SEN group and EN group were obviously higher, and the GCS showed significant increase while the NIHSSmarkedly decreased. And also the complication rate was lower in SEN group and EN group than that in control group.Conclusion:Since the nutritional conditions were deteriorated in elderly patients with severe stroke with the duration of stroke, enteral nutritionalsupport can improve nutritional status, enhance immune function, reduce the complication rates and improve clinical prognosis. And thesequential enteral nutrition support was more effective than the enteral nutrition support.