早期个体化肠内营养在脑卒中后吞咽功能障碍患者中的应用效果

Abstract
Figure/Table
References (28)
Related Citation (15)

Download: PDF (650 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore the effect of early individualized enteral nutrition on patients with swallowing dysfunction after stroke. Methods A total of 125 patients with stroke and swallowing dysfunction who received nasogastric tube feeding in Shanghai Fourth Rehabilitation Hospital from January 2018 to July 2020 were prospectively selected. They were divided into group A (63 cases, received individualized enteral nutrition support) and group B (62 cases, received home-made uniform diet support) according to random number table method. Nutritional status, complications and rehabilitation effect were compared between the two groups after 30 days of treatment. Results After 30 days of treatment, there were no significantly differences in hemoglobin, albumin, and prealbumin in group A compared with before treatment (P ＞ 0.05), while hemoglobin, albumin, and prealbumin in group B were lower than those before treatment and the group A were higher than those in group B, the differences were statistically significant (P ＜ 0.05). The incidence of pulmonary infection and gastrointestinal complications (gastric retention, constipation, and diarrhea) in group A were lower than those in group B, and the differences were statistically significant (P ＜ 0.05). After 30 days of treatment, simplified Fugl-Meyer motor function score, mini-mental state test and modified Barthel index in two groups were higher than before, and group A was higher than group B, and the differences were statistically significant (P ＜ 0.05). Conclusion The early individualized enteral nutrition treatment according to the actual condition of the stroke patients with swallowing dysfunction, can effectively improve the patient’s nutritional status, promote recovery, and reduce lung infection and gastrointestinal complications.

Key words： Stroke Individualized enteral nutrition Nutritional status Complications Rehabilitation effects

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LU Chunhua1 WANG Kai2 ZENG Zhen2 SUN Leimin1

Cite this article:

LU Chunhua1 WANG Kai2 ZENG Zhen2 SUN Leimin1. Effect of early individualized enteral nutrition in patients with swallowing dysfunction after stroke#br#[J]. 中国医药导报, 2021, 18(35): 117-120,137.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I35/117

[1] Shimizu A，Maeda K，Koyanagi Y，et al. The Global Leadership Initiative on Malnutrition-Defined Malnutrition Predicts Prognosis in Persons With Stroke-Related Dysphagia [J]. J Am Med Dir Assoc，2019，20（12）：1628-1633.
[2] Hota S，Inamoto Y，Oguchi K，et al. Outcomes of Dysphagia Following Stroke： Factors Influencing Oral Intake at 6 Months After Onset [J]. J Stroke Cerebrovasc Dis，2021，30（9）：105971.
[3] 罗阿兰，张慧敏，程美芳，等.肠内营养支持对急性脑卒中伴吞咽障碍患者疗效的Meta分析[J].中国老年学杂志，2020，40（21）：4502-4510.
[4] 陈莲珍，费小非，李璐，等.肠内营养制剂产品配方评价[J].临床药物治疗杂志，2019，17（4）：43-46.
[5] Irisawa H，Mizushima T. Correlation of Body Composition and Nutritional Status with Functional Recovery in Stroke Rehabilitation Patients [J]. Nutrients，2020，12（7）：1923.
[6] 中华神经科学会，中华神经外科学会.各类脑血管疾病诊断要点（1995）[J]．中华神经科杂志，1996，29（6）：379-380．
[7] 王桂兰，郭红桃.早期康复护理对颅神经损伤致吞咽困难患者的影响[J].实用临床医药杂志，2017，21（6）：87-90.
[8] 路潜，孙大力，蒋朱明，等营养风险-不足-支持-结局-成本/效果比第12届论坛与第39次工作坊纪要-营养风险筛查工具2002工具前瞻性临床有效性验证是其国内推广基础[J].中华临床营养杂志，2017，25（6）：391-392.
[9] 王云霄，袁俊亮，胡文立.常用卒中量表的研究进展[J].中国卒中杂志，2016，11（12）：1072-1077.
[10] Shimazu S，Yoshimura Y，Kudo M，et al. Frequent and personalized nutritional support leads to improved nutritional status，activities of daily living，and dysphagia after stroke [J]. Nutrition，2021，83：111091.
[11] 《中国食物成分表》标准版第6版第一二册出版[J].营养学报，2019，41（5）：426.
[12] 刘艳瑰，黄英.脑卒中恢复期患者营养风险筛查及营养评估[J].中国医药科学，2021，11（8）：163-165.
[13] 张恺，凌文杰.综合康复干预对脑卒中偏瘫患者肢体功能恢复的影响[J].中华物理医学与康复杂志，2020，42（3）：249-251.
[14] Suda S，Muraga K，Ishiwata A，et al. Early Cognitive Assessment Following Acute Stroke： Feasibility and Comparison between Mini-Mental State Examination and Montreal Cognitive Assessment [J]. J Stroke Cerebrovasc Dis，2020，29（4）：104688.
[15] 周海燕，陈多妹，王陈军.改良Barthel指数评定量表在脑卒中患者中的应用及影响效果分析[J].中国药物与临床，2018，18（12）：2259-2261.
[16] Maruyama K，Nakagawa N，Koyama S，et al. Malnutrition Increases the Incidence of Death，Cardiovascular Events，and Infections in Patients with Stroke after Rehabilitation [J]. J Stroke Cerebrovasc Dis，2018，27（3）：716-723.
[17] Jaafar MH，Mahadeva S，Tan KM，et al. Long-Term Nasogastric Versus Percutaneous Endoscopic Gastrostomy Tube Feeding in Older Asians With Dysphagia：A Pragmatic Study [J]. Nutr Clin Pract，2019，34（2）：280-289.
[18] 丁里，王拥军，王少石，等.卒中患者吞咽障碍和营养管理的中国专家共识（2013版）[J].中国卒中杂志，2013，（12）：973-983.
[19] 姜嵋，冯婧.个体化肠内营养支持对重症脑卒中患者营养状态和并发症的影响[J].中国药师，2017，20（7）：1265-1267.
[20] Chen N，Li Y，Fang J，et al. Risk factors for malnutrition in stroke patients：A meta-analysis[J]. Clin Nutr，2019， 38（1）：127-135.
[21] 朱娟，王龙安，秦历杰，等.肠内营养序贯疗法在重症脑血管病的应用[J].中华急诊医学杂志，2018，27（8）：872-875.
[22] 秦殊，顾宇丹，费雅雅，等.早期肠内营养和延期肠内营养对重型颅脑外伤患者术后的影响比较[J].中国医药导报，2020，538（8）：88-91.
[23] 戴竹泉，嵇朝晖，潘慧斌，等.早期肠内营养对重症颅脑损伤患者炎症反应和胃肠道功能的影响[J].中国现代医生，2021，59（19）：100-103.
[24] 范春江，刘庭玉，李刚，等.肠内营养对缺血性脑卒中患者肠道菌群的影响[J].中国康复理论与实践，2019，25（7）：822-827.
[25] 张洋洋，莫延红，张兆辉.脑卒中相关性肺炎的研究进展[J].卒中与神经疾病，2020，27（2）：259-263.
[26] 韩琳，张莹，高宇，等.T淋巴细胞亚群变化对脑卒中相关性肺炎的预测价值探讨[J].临床和实验医学杂志，2020，310（6）：614-617.
[27] 李松，邵宏元，张永红，等.重症脑出血患者采用不同营养剂行早期肠内营养支持治疗的临床效果比较[J].中国医药，2019，14（3）：70-72.
[28] Kishimoto H，Yozu A，Kohno Y，et al. Nutritional improvement is associated with better functional outcome in stroke rehabilitation： A cross-sectional study using controlling nutritional status [J]. J Rehabil Med，2020，52（3）：jrm00029.