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目的探讨早期肠内营养支持对重症脑卒中患者营养和免疫功能的影响。方法选取2013年9月—2014年10月玉林市第二人民医院收治的重症脑卒中患者88例,按照患者入院尾号奇偶数分为A组45例与B组43例。A组患者给予早期肠内营养支持,B组患者给予肠外营养支持,观察两组患者机体免疫功能〔免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)〕、机体营养改善情况〔血红蛋白(Hb)、血清蛋白(ALB)以及三酰甘油(TG)〕、预后及并发症。结果 Ig A、Ig G及Ig M时间与方法有交互作用(P<0.05),组间比较,差异有统计学意义(P<0.05),时间间比较,差异有统计学意义(P<0.05)。治疗1d、10d两组患者Ig A、Ig G及Ig M水平比较,差异无统计学意义(P>0.05);治疗21d,A组Ig A、Ig G及Ig M水平高于B组,差异有统计学意义(P<0.05)。ALB、Hb及TG时间与方法有交互作用(P<0.05),组间比较,差异有统计学意义(P<0.05),时间间比较,差异有统计学意义(P<0.05)。治疗1d、10d两组患者ALB、Hb及TG水平比较,差异无统计学意义(P>0.05);治疗21d,A组患者ALB、Hb及TG水平高于B组,差异有统计学意义(P<0.05)。两组患者病死率比较,差异无统计学意义(P>0.05)。A组患者并发症发生率低于B组,差异有统计学意义(P<0.05)。结论早期肠内营养支持治疗重症脑卒中患者的临床疗效确切,可有效改善患者机体营养状况,提高免疫功能,并降低并发症发生率。
Objective To investigate the effect of early enteral nutrition support on nutrition and immune function in patients with severe stroke. Methods Seventy-eight patients with severe stroke who were treated in Yulin Second People’s Hospital from September 2013 to October 2014 were divided into group A (45 cases) and group B (43 cases) according to the odd-even number of patients. Group A patients were given early enteral nutrition support, Group B patients were given parenteral nutrition support to observe the immune function of two groups of patients [IgA, IgG, IgM (immunoglobulin M Ig M)], nutritional status of the body (hemoglobin (Hb), serum albumin (ALB) and triglyceride (TG)], prognosis and complications. Results There was interaction between Ig A, Ig G and Ig M time and the method (P <0.05). There was significant difference between the two groups (P <0.05), and the difference was statistically significant (P <0.05) . There was no significant difference in Ig A, Ig G and Ig M levels between the two groups on the 1st day and the 10th day after treatment (P> 0.05). On the 21st day after treatment, the levels of Ig A, Ig G and Ig M in group A were higher than those in group B Statistical significance (P <0.05). ALB, Hb and TG time had interaction with the method (P <0.05). There was significant difference between the two groups (P <0.05). There was significant difference between the two groups in time (P <0.05). There was no significant difference in ALB, Hb and TG levels between the two groups on the 1st and 10th day after treatment (P> 0.05). On the 21st day after treatment, the levels of ALB, Hb and TG in the A group were significantly higher than those in the B group <0.05). There was no significant difference in mortality between the two groups (P> 0.05). The incidence of complications in group A was lower than that in group B, the difference was statistically significant (P <0.05). Conclusion Early enteral nutrition support for patients with severe stroke clinical efficacy is exact, can effectively improve the patient’s nutritional status, improve immune function, and reduce the incidence of complications.