果胶加间断输注肠内营养剂在脑卒中伴吞咽障碍患者的应用

doi:10.16460/j.issn1008-9969.2019.14.055

摘要/Abstract

摘要： 目的探讨果胶加间断输注肠内营养制剂对脑卒中伴吞咽障碍患者的早期肠内营养的耐受性及热量达标率影响。方法选取我院2017年10月—2018年11月入住神经内科且需要留置胃管行肠内营养的卒中伴吞咽障碍患者。按照随机对照的原则分为观察组和对照组各64例。观察组采用鼻饲蕊福平果胶加间断输注肠内营养制剂,对照组给予肠内营养制剂持续输注。比较2组患者1周内肠内营养不耐受发生率（包括呕吐、腹泻、便秘、腹胀、误吸、胃潴留的发生率差异,比较肠内营养实施第3天、第7天2组患者热量达标率差异。结果观察组肠内营养期间呕吐、腹泻、误吸、腹胀的发生率低于对照组（P<0.05,但在胃潴留、便秘的发生率与对照组差异无统计学意义（P>0.05。干预第3天、第7天,观察组的肠内营养热量达标率高于对照组（P<0.05。结论给予果胶加间断输注肠内营养制剂与连续输注肠内营养制剂相比,可以降低脑卒中患者早期肠内营养过程中腹泻、误吸、腹胀、呕吐的发生率,同时提高患者早期热量达标率。

关键词: 脑卒中, 吞咽障碍, 肠内营养, 果胶, 体内半固化

Abstract: Objective To investigate the effects of pectin and continuous enteral nutrition (EN on the tolerance of early EN and the rate of meeting EN needs in patients with stroke and dysphagia. Methods The patients with stroke and dysphagia admitted to the Department of Neurology from October 2017 to November 2018 and required to indwell gastric tube for enteral nutrition were selected and divided into observation group and control group, with 64 patients in each group. The in vivo semi-curing infusion method of Ruifuping pectin and enteral nutrition was used in the observation group, and traditional continuous EN infusion method in the control group. The intolerance of EN within one week was analyzed, including the incidences of vomiting, diarrhea, constipation, abdominal distension, aspiration and gastric retention. The rate of meeting EN needs on the third and seventh day were measured in the two groups. Results The incidences of vomiting, diarrhea, abdominal distension and aspiration in the early stage of EN in the observation group were lower than those in the control group (P<0.05, and the differences were statistically significant, while there was no statistical difference between the incidence of gastric retention and constipation (P>0.05. The rate of meeting EN needs on the third day and seventh day in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05. Conclusion Compared with traditional infusion methods, in vivo semi-curing infusion method of pectin and EN can reduce the incidences of diarrhea, aspiration, abdominal distension and vomiting during early EN and improve the rate of meeting EN needs, which is worthy of clinical promotion.

Key words: stroke, dysphagia, enteral nutrition, pectin, in vivo semi-curing

中图分类号:

R473.74

臧丽丽, 时敏秀, 张旋, 唐亚男. 果胶加间断输注肠内营养剂在脑卒中伴吞咽障碍患者的应用[J]. 护理学报, 2019, 26(14): 55-58.

ZANG Li-li, SHI Min-xiu, ZHANG Xuan, TANG Ya-nan. Effect of Pectin and Continuous Infusion of Enteral Nutrition in Stroke Patients with Dysphagia[J]. Journal of Nursing, 2019, 26(14): 55-58.

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