Comparison of the clinical effects of early enteral and parenteral nutrition support in patients with severe stroke

中国基层医药 Pub Date : 2020-03-01 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.05.015

W. Shi

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Abstract

Objective To compare the clinical effects of early enteral and parenteral nutrition support in patients with severe stroke. Methods From June 2017 to July 2018, 65 patients with severe stroke admitted in the First People's Hospital of Yongkang were selected in the study, and the patients were randomly divided into control group(32 cases) and observation group(33 cases) according to the digital table.The control group received early parenteral nutrition support, while the observation group received early enteral nutrition support.The nutritional index, biochemical index, NIHSS score, CPIS score of clinical pulmonary infection and the incidence of complications were compared between the two groups. Results After nutritional support, the serum levels of total protein(TP), albumin(Alb), hemoglobin(Hb) in the observation group were (57.01±2.59)g/L, (39.98±2.64)g/L, (126.86±10.75)g/L, respectively, which were significantly higher than those in the control group [(54.28±0.76)g/L, (37.31±2.35)g/L, (120.75±13.46)g/L](t=5.727, 4.302, 2.025, all P<0.05). The serum levels of glucose(GLU), creatinine (SCr), alanine aminotransferase (ALT) in the observation group were (12.35±2.38)mmol/L, (84.37±13.62)μmol/L, (47.84±4.03)U/L, respectively, which were lower than those in the control group [(14.18±2.37)mmol/L, (91.84±13.21)μmol/L, (66.28±3.76)U/L] (t=3.106, 2.244, 19.060, all P<0.05). The levels of triglyceride(TG), serum urea nitrogen(BUN) in the observation group were (1.95±0.45)mmol/L, (5.80±0.61)mmol/L, respectively, which were higher than those in the control group [(1.66±0.30)mmol/L, (5.32±0.43)mmol/L] (t=0.341, 3.656, all P<0.05). The scores of NIHSS and CPIS in the observation group were (10.31±2.10)points and (3.00±0.76)points, respectively, which were lower than those in the control group [(14.68±2.75)points, (3.79±1.45)points](t=5.279, 2.763, P=0.001, 0.008). The incidence of complications in the observation group [9.38%(3/33)] was lower than that in the control group [31.25%(10/32)], and the difference was statistically significant(χ2=4.986, P<0.05). Conclusion Compared with early parenteral nutrition support, early enteral nutrition support can improve the nutritional status of patients with severe stroke and is safe and effective. Key words: Stroke; Enteral nutrition; Parenteral nutrition; Nutritional support; Albumins; Serum albumin; Hemoglobins; Comparative effectiveness research

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重型脑卒中患者早期肠内与肠外营养支持的临床效果比较

目的比较早期肠内和肠外营养支持在严重脑卒中患者中的临床效果。方法选择2017年6月至2018年7月在永康市第一人民医院住院的65例重型脑卒中患者，根据数字表将患者随机分为对照组（32例）和观察组（33例）。对照组给予早期肠外营养支持，观察组给予早期肠道营养支持。比较两组临床肺部感染的营养指标、生化指标、NIHSS评分、CPIS评分及并发症发生率。结果营养支持后，观察组血清总蛋白（TP）、白蛋白（Alb）、血红蛋白（Hb）水平分别为（57.01±2.59）g/L、（39.98±2.64）g/L和（126.86±10.75）g/L，显著高于对照组[（54.28±0.76）g/L、，肌酐（SCr）、丙氨酸氨基转移酶（ALT）分别为（12.35±2.38）mmol/L、（84.37±13.62）μmol/L、（47.84±4.03）U/L，均低于对照组[（14.18±2.37）mmol/L，（91.84±13.21）μmol/L，（66.28±3.76）U/L]（t=3.106，2.244，19.060，均P<0.05），观察组血清尿素氮（BUN）分别为（1.95±0.45）mmol/L、（5.80±0.61）mmol/L，高于对照组[（1.66±0.30）mmol/L和（5.32±0.43）mmol/L]（t=0.341、3.656，均P<0.05），低于对照组[（14.68±2.75）分，（3.79±1.45）分]（t=5.279，2.763，P=0.001，0.008）。观察组并发症发生率[9.38%（3/33）]低于对照组[31.25%（10/32）]，差异有统计学意义（χ2=4.986，P<0.05），早期肠内营养支持可以改善严重脑卒中患者的营养状况，是安全有效的。关键词：笔画；肠道营养；肠外营养；营养支持；白蛋白；血清白蛋白；血红蛋白；比较有效性研究

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.