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目的:评价高脂肪EN液对脑卒中病人营养状况和预后的影响。方法:将56例脑卒中病人随机分为高脂肪营养液(瑞能)组和标准营养液(Nutrison Fiber)对照组,每组28例。于住院营养支持前,营养支持第1、10和21天分别检测两组病人的血糖、Hb、血清ALB、TG、TC、HDL和LDL水平以及美国国立卫生院卒中量表(NIHSS)评分。观察病人EN支持过程中胃肠道不良反应的发生情况。入院30 d时,进行日常生活能力量表(ADL)评定。结果:两组病人EN支持第1天各项指标与营养支持前相比无显著性差异。EN支持第10和21天时,对照组病人各项营养指标除Glu外均有下降;高脂肪营养组病人仅血清ALB水平有一定程度的下降,血脂维持在正常水平。两组病人胃肠道并发症无显著性差异。第21天时,高脂肪营养组病人NIHSS评分改善较对照组更为显著(P<0.01),第30天高脂肪营养组ADL评分明显好于对照组(P<0.01)。结论:早期高脂肪EN支持可明显改善重症脑卒中病人的营养状况,改善预后,不会升高血脂。
Objective: To evaluate the effect of high-fat EN solution on nutritional status and prognosis of stroke patients. Methods: Fifty-six patients with stroke were randomly divided into two groups: high-fat nutrition group (Ruinen) group and Nutrison Fiber control group, 28 cases in each group. Blood glucose, Hb, serum ALB, TG, TC, HDL, and LDL levels and National Institutes of Health Stroke Scale (NIHSS) scores were measured on day 1, day 10 and day 21 before hospitalization for nutritional support. Observe the occurrence of gastrointestinal adverse reactions in patients with EN support. At 30 days after admission, ADL was assessed. Results: There was no significant difference between the two groups on the first day of EN support and before nutritional support. EN support on the 10th and 21st days, the control group of patients with nutritional indicators except Glu have declined; high fat diet group only serum ALB levels to some extent decreased blood lipids maintained at normal levels. There was no significant difference in gastrointestinal complications between the two groups. On the 21st day, the NIHSS scores of the patients in the high fat diet group were significantly improved compared with the control group (P <0.01). The ADL score of the high fat diet group on the 30th day was significantly better than that of the control group (P <0.01). Conclusion: Early high-fat EN support can significantly improve the nutritional status of patients with severe stroke, improve prognosis, will not increase blood fat.