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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。
Objective: To investigate the effects of sequential enteral nutrition on nutritional metabolism, immune function and prognosis in elderly patients with severe stroke. Methods: Ninety elderly patients with severe stroke were randomly divided into sequential enteral nutrition group (n = 30), enteral nutrition group (n = 30) and control group (n = 30). Nutritional indexes, immune function, Glasgow Coma Scale (GCS) and National Institutes of Health Neurological Deficit (NIHSS) scores were detected on the first day and the 14th day after admission. The complication rates of the three groups were calculated. Results: After 14 days of treatment, the indexes of three groups were significantly decreased compared with those on the first day. The control group was more obvious than the sequential enteral nutrition group and enteral nutrition group. Compared with the control group, the sequential enteral nutrition The levels of TLC, IgA, IgM and IgG in group and enteral nutrition group were significantly increased; the GCS score was significantly higher and the NIHSS score was significantly lower; the incidence of complications in sequential enteral nutrition group and enteral nutrition group was lower than that in control group . Conclusion: The elderly patients with severe stroke with the prolonged course of the nutritional status showed a deteriorating trend. Enteral nutrition can improve the patient’s nutritional status, improve immune function, reduce the incidence of complications and improve prognosis. Sequential enteral nutrition better than enteral nutrition.