Nutritional risk screening and nutritional support survey of patients with severe stroke
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摘要: 目的 探讨营养风险筛查（nutritional risk screening，NRS）用于评估重症脑卒中患者营养状态的意义，比较肠内外营养支持治疗对该类患者的临床应用价值。 方法 采用回顾性调查方法，对267例重症脑卒中患者根据营养风险筛查2002版[2002年欧洲肠外肠内营养学会（ESPEN）推荐的成人营养风险筛查方法，NRS 2002]进行营养评估，并根据营养支持类型分为3组，包括肠内营养（EN）组、肠外营养（PN）组和联合营养（EN+PN）组，通过比较使用前后各项指标的变化情况，对各组的临床疗效和不良反应进行评价。 结果 通过比较患者入院第1天与第10天的营养状况、肝肾功能及并发症情况，发现EN组、EN+PN组相对用药前的总蛋白、白蛋白水平有显著性提高（P<0.05），且EN组肝肾功能指标变化较小，合并感染的发生率为16.67%。 结论 肠内营养支持能有效改善重症脑卒中患者的营养状况，降低患者感染及胃肠道并发症的发生率，明显改善患者预后。Abstract: Objective To discuss the signficance using nutrtional risk screening (NRS) to evaluate nutritional status in patients with severe stroke. In the meantime compare the clinical application value between enteral and parenteral nutritional support therapies. Methods A retrospective survey was adopted to analyze the nutritional status in 267 patients with severe stroke. Their nutritional statuses were evaluated by NRS 2002 nutrtional risk screening. Patients were divided into three groups, including enteral nutrition (EN) group, parenteral nutrition (PN) group and EN+PN group based on the type of their nutritional support. By comparing changes of indicators before and after of adiministration of nutritional support, the clinical efficacy and adverse reactions for each group were evaluated. Results In EN group and EN+PN group total protein and albumin level were significantly increased after 10 days nutritional support (P<0.05). Small changes in patients' liver and kidney function indices in EN group. The incidence of co-infection was 16.67% in EN group, which was lowest among three groups. Conclusion Enteral nutrition support could not only improve the nutritional status of patients with severe stroke, but also could reduce the incidence of infections and gastrointestinal complications. It significantly improves the prognosis of patients.
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[1] Galban C, Montejo JC, Mesejo A, et al. An immune enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients[J]. Crit Care Med, 2000, 28(3): 643-648. [2] 王少石,Chan DK,Gillies D.急性脑卒中综合性治疗模式的优越性[J].中华内科杂志,2002,41(11):725-727. [3] 王少石,郑天衡,陈真理,等.早期肠内营养治疗对急性卒中近期预后的影响[J].中华内科杂志,2007,46(5):366-369. [4] Lochsa H,Al1isonb SP,Meierc R. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions, and general topics[J]. Clin Nutr,2006, 25(2):180-186. [5] 中华医学会编辑出版部.法定计量单位在医学上的应用[M].2版.北京:人民军医出版杜,1998:37. [6] 蒋朱明.中国肠内肠外营养学临床诊疗指南[M].北京:人民卫生出版社,2006:322. [7] FOOD Trial Collaboration. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial[J].Stroke,2003,34(6):1450-1456. [8] Donnan GA, Dewey HM. Stroke and nutrition: FOOD for thought[J].Lancet, 2005, 365(9461): 729-730. [9] 崔丽英,陈海波,宿英英,等.北京大医院神经科住院患者营养风险、营养不足、超重和肥胖发生率及营养支持应用状况[J].中华临床营养杂志,2009,17(2):67-70. [10] Kondrup J, Rasmussen HH, Hamberg O,et al.Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J].Clin Nutr,2003,22(3):321-336. [11] 魏 丽,陈济生,杨倩琳,等.肠内外联合营养支持对急性脑卒中患者临床价值的回顾性调查研究[J].军事医学,2011,35(3):223-228. [12] Goldstein LB,Bushnell CD,Adams RJ,et al.Guidelines for the primary prevention of stroke:a guideline for health care professionals from the American Heart Association/American Stroke Association[J].Stroke,2011,42(2):517-584. -
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