|
|
不同肠内营养对脑出血昏迷患者医院获得性肺炎的临床影响
|
Abstract:
目的：分析探讨不同肠内营养对脑出血昏迷患者医院获得性肺炎的临床影响。方法：选取我院2022年7月至2024年7月收治的100名脑出血昏迷患者，将所有患者按照治疗方法的不同，分为50例对照组和50例观察组，分别采用经鼻胃管肠内营养和经鼻肠管肠内营养这两种不同的肠内营养支持。治疗结束后，比较两组患者的炎症因子检测、营养指标、HAP的诊断、肠道菌群分析等指标差异。结果：1) 分析对比两组患者的治疗总有效率：观察组的治疗总有效率明显高于对照组，差异有统计学意义(P < 0.05)。2) 分析对比两组患者并发症情况：观察组的并发症发生率明显低于对照组，差异有统计学意义(P < 0.05)。结论：在急性脑出血昏迷患者中采用经鼻肠管进行肠内营养支持，能够在一定程度上改善患者的胃肠动力和营养状况，从而有效提升患者的免疫能力，减轻炎症反应，降低患者的并发症风险，对患者预后改善具有重要意义，且安全性好，值得临床推广应用。
Objective: To analyze and explore the clinical effects of different enteral nutrition on hospital-acquired pneumonia in comatose patients with cerebral hemorrhage. Methods: 100 comatose patients with cerebral hemorrhage admitted to our hospital from July 2022 to July 2024 were selected. All patients were divided into a control group of 50 cases and an observation group of 50 cases according to different treatment methods, and received two different types of enteral nutrition support: nasogastric enteral nutrition and nasointestinal enteral nutrition. After treatment, the differences in inflammatory factor detection, nutritional indicators, HAP diagnosis, and gut microbiota analysis between the two groups of patients were compared. Results: 1) Analysis and comparison of the total effective rate of treatment between the two groups of patients: The total effective rate of treatment in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P < 0.05). 2) Analysis and comparison of the incidence of complications between two groups of patients: the incidence of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The use of nasointestinal enteral nutrition support in comatose patients with acute cerebral hemorrhage can improve the gastrointestinal motility and nutritional status of patients to a certain extent, effectively enhance their immune ability, reduce inflammatory reactions, and lower the risk of complications. It is of great significance for improving the prognosis of patients and has good safety, which is worthy of clinical promotion and application.
| [1] | 郭敏, 李炬带. 早期经鼻肠管管饲生大黄对重症脑出血并发胃瘫病人胃肠功能的影响[J]. 中西医结合心脑血管病杂志, 2021, 19(6): 1044-1047. |
| [2] | 贾艳红. 经鼻肠管肠内营养对脑出血患者营养状况和预后的影响[J]. 中国现代医生, 2016, 54(4): 77-79. |
| [3] | 吕志露, 梁向明, 李淑英, 等. 对比床旁盲插鼻肠管与库派鼻空肠管在重症脑出血患者中的应用分析[J]. 中国医药科学, 2022, 12(9): 180-183. |
| [4] | 王吉梁, 李保珍, 杨君亮, 等. 急性脑出血患者应用鼻肠管与鼻胃管进行肠内营养支持的效果分析[J]. 中华养生保健, 2022, 40(17): 34-36. |
| [5] | 朱琳, 潘强, 鲍冠君, 等. 内镜辅助下早期肠内营养对重症高血压脑出血患者免疫功能和炎症反应的影响[J]. 广东医学, 2022, 43(3): 362-366. |
| [6] | 黄从刚, 张严国, 罗明, 等. 经皮内镜下胃空肠造瘘术置管行肠内营养治疗重症脑出血患者的应用价值分析[J]. 中华神经医学杂志, 2020, 19(8): 810-815. |
| [7] | 刘汉锋, 厉喆, 孙瑞玥. 重症高血压脑出血术后不同时期不同鼻饲途径肠内营养干预的疗效比较[J]. 现代医学, 2020, 48(4): 468-474. |
| [8] | 高云峰. 两种肠内营养方式对高血压脑出血术后重症患者的效果比较[J]. 现代诊断与治疗, 2020, 31(19): 3114-3115. |
| [9] | 寇玉, 寇谦, 王笑, 等. 谷氨酰胺联合序贯肠内营养疗法对脑出血术后患者营养状态、胃动力指标及氧化应激指标的影响[J]. 临床医学研究与实践, 2022, 7(23): 31-35. |
| [10] | 王木梁, 刘竞辉, 郭少春, 等. 鼻胃管减压联合鼻肠管营养支持在神经外科重症患者术后加速康复中的作用[J]. 中华神经外科杂志, 2020, 36(8): 796-800. |
| [11] | 马丽娟, 方芳, 吕建森, 等. 护理治疗在危重症经鼻胃管早期肠内营养治疗患者中的应用分析[J]. 中国药物与临床, 2019, 19(20): 3641-3642. |
| [12] | 周娅, 陈倪. 经鼻肠管和鼻胃管肠内营养对重型颅脑损伤患者预后及并发症的影响[J]. 解放军预防医学杂志, 2019, 37(3): 72-74. |
| [13] | 马淮滨, 张冉. 早期肠内营养对高血压脑出血患者肠道菌群、营养指标及神经功能的影响[J]. 中国现代医学杂志, 2021, 31(12): 83-86. |
| [14] | 刘永福, 郑以山. 老年重症肺炎病人营养支持治疗的疗效观察[J]. 肠外与肠内营养, 2017, 24(2): 98-100. |
| [15] | 李书雯, 石仁芳. 肝硬化患者肠内营养支持的研究进展[J]. 广西医学, 2018, 40(18): 76-78. |
| [16] | 孙萱, 张杰, 李佳欢, 等. 早期肠内营养支持在大面积重度烧伤患者中的应用效果[J]. 中国食物与营养, 2018, 24(9): 66-68. |
| [17] | McClave, S.A., Taylor, B.E., Martindale, R.G., Warren, M.M., Johnson, D.R., Braunschweig, C., et al. (2016) Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient. Journal of Parenteral and Enteral Nutrition, 40, 159-211. https://doi.org/10.1177/0148607115621863 |
| [18] | DeBellis, H.F. and Fetterman, J.W. (2012) Enteral Nutrition in the Chronic Obstructive Pulmonary Disease (COPD) Patient. Journal of Pharmacy Practice, 25, 583-585. https://doi.org/10.1177/0897190012460827 |
| [19] | Toussaint, E., Van Gossum, A., Ballarin, A. and Arvanitakis, M. (2015) Enteral Access in Adults. Clinical Nutrition, 34, 350-358. https://doi.org/10.1016/j.clnu.2014.10.009 |
| [20] | 刘莺, 周卫萍. 足月新生儿急性呼吸窘迫综合征的高危因素及临床特点分析[J]. 当代医学, 2015, 21(20): 97-98. |
| [21] | 常春玲, 孙鸿, 林林, 等. 不同分娩方式足月儿急性呼吸窘迫综合征的发生率及其影响因素分析[J]. 现代医学, 2017, 45(2): 268-271. |
| [22] | 包道成, 蔡金兰, 卞洪亮, 等. 新生儿肺出血高危因素的临床分析[J]. 江苏医药, 2017, 43(1): 64-65. |
| [23] | 李建华, 韩玲. 不同肠内营养制剂对危重患者血糖及炎症因子水平的影响[J]. 现代诊断与治疗, 2018, 29(5): 761-763. |
| [24] | 古孜丽努尔∙吐尼亚孜, 余泽泓, 古丽娜∙艾尔肯, 等. 乌司他丁联合利奈唑胺对重症肺炎患者血清PCT、CRP、TNF-α及白细胞计数的影响[J]. 现代生物医学进展, 2019, 19(8): 1494-1497, 1481. |
| [25] | Ventura, C.L., Higdon, R., Kolker, E., Skerrett, S.J. and Rubens, C.E. (2008) Host Airway Proteins Interact with Staphylococcus aureus during Early Pneumonia. Infection and Immunity, 76, 888-898. https://doi.org/10.1128/iai.01301-07 |
| [26] | 赵航, 赵丛海, 李桂杰, 等. 神经外科基础疾病合并医院获得性肺炎危险因素荟萃分析[J]. 中华医院感染学杂志, 2011, 21(16): 3352-3354. |
