不同肠内营养方式对老年卒中患者营养状况的影响

Effect of Different Enteral Nutrition on Nutritional Status of Elderly Stroke Patients

摘要: 背景及目的：营养物质是人类生命活动的基石之一，并且在诸多方面影响着人类的生命活动。营养物质的异常减少或增多都可以导致人体发生相关疾病。急性脑卒中是现阶段全球范围内影响人类生存质量最主要的疾病之一。现有研究表明营养物质对此疾病有着深刻而又广泛的影响。因为营养物质对于脑卒中的影响不仅仅局限于疾病发生后神经功能的恢复，且对疾病的发生率、病理生理过程有着重要影响。本研究着重探究老年卒中患者在经不同营养方式、给予不同营养物质后，其营养状况与发病后神经功能恢复间的关系，以期找出临床中何种营养方案更为合理有效。方法：根据纳入和排除标准选取60例老年脑卒中患者(60~80岁)作为研究对象。将所选取对象分为试验组(整蛋白组)和对照组(匀浆膳食组)。采集病例资料包括：患者基本信息、神经功能评分、体重指数、血浆白蛋白、血浆总蛋白、肱三头肌皮肤厚度以及上臂周径。数据整理及分析采用Excel 2007和SPSS 22.0软件。正态分布的定量采用均数加减标准差($\overline{x}\pm s$ )表示，两组比采用t检验，重复测量资料比较采用重复测量方差分析，定性资料比较采用χ²检验，P < 0.05为差异有统计学意义。结果：试验组与对照组比较：治疗前两组收集到的各项数据比较，均P > 0.05，差异无统计学意义，具有可比性。治疗1周后，整蛋白组TP水平高于匀浆膳食组(P < 0.05)。治疗1月后，整蛋白组ALB、TP水平高于匀浆膳食组(P < 0.05)。试验组及对照组组内数据比较比较：匀浆膳食组：治疗1周后和治疗1月后，AMC、TSF、ALB和TP水平低于治疗前；治疗1周后，Cl⁻离子水平低于治疗前，均P < 0.05，差异有统计学意义。结论：在我们收集到的数据中，可以观察到患者的营养状态较患病前有改变，有效地营养干预在很大可能上可以改善患者的营养状态。

Abstract: Background and purpose: Nutrients are one of the cornerstones of human life activities, and affect human life activities in many aspects. Abnormal decrease or increase of nutrients can lead to related diseases. Acute stroke is one of the most important diseases affecting the quality of human life in the world at this stage. Because of the serious consequences brought by the irreversible necrosis of nerve cells, the research of this disease has never stopped. Because the impact of nutrients on stroke is not only limited to the recovery of neurological function after the occurrence of the disease, but also has an important impact on the incidence of the disease and the pathophysiological process of the disease. This study mainly discusses the interaction among nutrition mode, nutrition and stroke. This study focuses on the relationship between the nutritional status of patients and the recovery of neurological function after the onset of the disease, and observe which nutritional scheme is more reasonable and effective. Method: According to the inclusion and exclusion criteria, 60 elderly stroke patients (60~80 years old) were selected as the study object. The subjects were divided into experimental group (whole protein group) and control group (homogenate diet group). The data collected were basic information, neurological score, body mass index, plasma albumin, plasma total protein, triceps brachii skin thickness and circumference of upper arm. Excel 2007 and SPSS 22.0 software were used for data processing and analysis. The normal distribution was quantified by means of mean plus minus standard deviation, the ratio of the two groups was t-test, the repeated measurement data was compared by means of repeated measurement analysis of variance, the qualitative data was compared by means of χ² test, P < 0.05 was statistically significant. Result: Comparison between the experimental group and the control group: the data collected from the two groups before the treatment were all P > 0.05, the difference was not statistically significant and comparable. After one week of treatment, the TP level in the whole protein group was higher than that in the homogenate diet group (P < 0.05). One month after treatment, the ALB and TP levels in the whole protein group were higher than those in the homogenate diet group (P < 0.05). Data comparison between the experimental group and the control group: the level of AMC, TSF, ALB and TP in the homogenate diet group was lower than that before treatment after 1 week and 1 month of treatment; after 1 week of treatment, the level of Cl⁻ levels lower than before treatment, all P < 0.05, the difference was statistically significant. Conclusion: In the data we collected, we can observe that the nutritional status of patients has changed compared with that before the disease. Effective nutrition intervention can improve the nutritional status of patients.