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目的:评价高蛋白肠内营养(EN)制剂对老年脑卒中病人营养状况的影响。方法:将104例老年脑卒中病人随机分为高蛋白EN组和标准EN组,每组52例。于入院营养支持前、营养支持第1和第2周分别检测两组病人的空腹血糖(Glu)、Hb、血清总蛋白(TP)、清蛋白(ALB)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)等水平,观察病人营养支持过程中胃肠道不良反应的发生情况和患病3个月内生存率和病死率。结果:两组病人营养支持第1周TP、ALB、Hb和HDL均下降,高蛋白EN组Glu、TG升高,标准EN组TG、TC、LDH下降。高蛋白EN组病人Hb、TG、TC和LDL均高于标准EN组,营养支持第2周ALB就回升,TG和HDL下降;而标准EN组TP、ALB、TC和HDL继续下降。高蛋白EN组低蛋白血症的发生率明显低于标准EN组。两组病人胃肠道并发症和3个月生存率无显著性差异。结论:高蛋白EN制剂可改善老年脑卒中病人的营养状况,减少低蛋白质血症的发生率。
Objective: To evaluate the effect of high protein enteral nutrition (EN) on the nutritional status of senile stroke patients. Methods: 104 senile stroke patients were randomly divided into high protein EN group and standard EN group, with 52 cases in each group. Nutritional support before and 1 and 2 weeks after nutritional support were measured in two groups of patients fasting blood glucose (Glu), Hb, serum total protein (TP), albumin (ALB), triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were measured. The incidence of gastrointestinal adverse reactions and the three-month survival and mortality were observed during nutritional support. Results: The levels of TP, ALB, Hb and HDL decreased in the first week of the two groups. The levels of Glu and TG increased in the high protein EN group and decreased in the standard EN group. The levels of Hb, TG, TC and LDL in high-protein EN group were higher than those in standard EN group. The ALB returned to nutrition support in the second week and decreased in TG and HDL. The levels of TP, ALB, TC and HDL in standard EN group continued to decline. The incidence of hypoproteinemia in the high-protein EN group was significantly lower than that in the standard EN group. There were no significant differences in gastrointestinal complications and 3-month survival between the two groups. Conclusion: The high protein EN preparation can improve the nutritional status of elderly stroke patients and reduce the incidence of hypoproteinemia.