免疫肠内营养支持治疗对重症脑卒中患者营养状况、免疫功能及预后的影响
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摘要
目的探讨免疫肠内营养支持治疗对重症脑卒中患者营养状况、免疫功能及预后的影响。方法将100例重症脑卒中患者随机均分为免疫肠内营养支持治疗组(A组)和常规肠内营养支持治疗组(B组),比较两组治疗效果。结果与B组相比,A组治疗后CD8~+水平降低(P<0.05),总蛋白、前清蛋白、白蛋白、血红蛋白、总胆固醇、三酰甘油、IgG、IgM、IgA、CD4~+及CD4~+/CD8~+升高(P<0.05)。A组治疗后GCS评分高于B组[(11.51±0.75)分vs.(10.32±0.82)分](P<0.05),并发症发生率低于B组(42.0%vs.64.0%)(P<0.05)。结论与常规肠内营养比较,对重症脑卒中患者给予免疫肠内营养支持治疗的疗效更好,且能有效提高患者免疫功能,改善预后。
Objective To investigate the effect of immune enteral nutrition support therapy on the nutritional status,immune function and prognosis in the patients with severe stroke.Methods A total of 100 patients with severe stroke was equally randomized into two groups.The patients in group A received immune enteral nutrition support therapy and those in group B received conventional enteral nutrition therapy.The clinical outcomes were compared between two groups.Results Compared with group B,the level of CD8~+was decreased,while the levels of total protein,prealbumin,albumin,hemoglobin,total cholesterol,triacylglycerol,IgG,IgM,IgA,CD4~+and CD4~+/CD8~+were increased after treatment in group A(P<0.05).The GCS score after treatment in group A was higher than that in group B [(11.51±0.75)points vs.(10.32±0.82)points](P<0.05),but the incidence of complications in group A was lower than that in group B(42.0% vs.64.0%)(P<0.05).Conclusion Compared to conventional enteral nutrition therapy,the immune enteral nutrition support in the treatment of patients with severe stroke has better clinical efficacy with improved immune function and prognosis.
Objective To investigate the effect of immune enteral nutrition support therapy on the nutritional status,immune function and prognosis in the patients with severe stroke.Methods A total of 100 patients with severe stroke was equally randomized into two groups.The patients in group A received immune enteral nutrition support therapy and those in group B received conventional enteral nutrition therapy.The clinical outcomes were compared between two groups.Results Compared with group B,the level of CD8~+was decreased,while the levels of total protein,prealbumin,albumin,hemoglobin,total cholesterol,triacylglycerol,IgG,IgM,IgA,CD4~+and CD4~+/CD8~+were increased after treatment in group A(P<0.05).The GCS score after treatment in group A was higher than that in group B [(11.51±0.75)points vs.(10.32±0.82)points](P<0.05),but the incidence of complications in group A was lower than that in group B(42.0% vs.64.0%)(P<0.05).Conclusion Compared to conventional enteral nutrition therapy,the immune enteral nutrition support in the treatment of patients with severe stroke has better clinical efficacy with improved immune function and prognosis.
引文
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[9]Burgermaster M,Slattery E,Islam N,et al.Regional comparison of enteral nutrition-related admission policies in skilled nursing facilities[J].Nutr Clin Pract,2016,31(3):342-348.
[10]Akashi T,Matsumoto K,Hashimoto R.Continuation of enteral nutrition and relief from vomiting by administration of a new formula:a case report[J].Clin Nutr Res,2017,6(4):306-309.
[11]胡曦丹,何金凤,王琲,等.肠内营养与质子泵抑制剂对脑卒中患者医院获得性肺炎的影响[J].中国药房,2016,27(11):1548-1550.
[2]Oshima T,Singer P,Pichard C.Parenteral or enteral nutrition:do you have the choice[J]?Curr Opin Crit Care,2016,22(4):292-298.
[3]石向群,包仕尧,王运良.鼻饲肠内营养支持对急性脑卒中康复的影响[J].江苏医药,2003,29(5):321-324.
[4]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007.
[5]Lizardi A,Zurutuza A,Ripa C,et al.CP-218analysis of the use of enteral nutrition monitored by pharmacists in hospital[J].Eur J Hosp Pharm,2016,23(Suppl 1):A96.
[6]张馨,衡卫卫,李姗姗,等.新型糖尿病肠内营养制剂改善急性重症缺血性脑卒中病人的血糖和胰岛素抵抗状态[J].肠外与肠内营养,2016,23(6):342-345.
[7]Alonso EF,Allende Bandrés MA,Alcácera López MA,et al.GM-014use and financial impact study of enteral nutrition in institutionalised patients linked to a pharmacy service[J].Eur J Hosp Pharm,2016,23(Suppl 1):A164.
[8]杜文杰.脑卒中合并胃潴留患者经鼻空肠管肠内营养的疗效观察[J].中国中西医结合急救杂志,2016,23(5):536-538.
[9]Burgermaster M,Slattery E,Islam N,et al.Regional comparison of enteral nutrition-related admission policies in skilled nursing facilities[J].Nutr Clin Pract,2016,31(3):342-348.
[10]Akashi T,Matsumoto K,Hashimoto R.Continuation of enteral nutrition and relief from vomiting by administration of a new formula:a case report[J].Clin Nutr Res,2017,6(4):306-309.
[11]胡曦丹,何金凤,王琲,等.肠内营养与质子泵抑制剂对脑卒中患者医院获得性肺炎的影响[J].中国药房,2016,27(11):1548-1550.