| 程艳丽,薛颖.高压氧联合早期肠内营养对脑梗死昏迷病人 41例的疗效[J].安徽医药,2022,26(7):1429-1432. |
| 高压氧联合早期肠内营养对脑梗死昏迷病人 41例的疗效 |
| Effect of hyperbaric oxygen combined with early enteral nutrition on 41 coma patients with cerebral infarction |
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| DOI：10.3969/j.issn.1009-6469.2022.07.036 |
| 中文关键词: 高压氧 肠道营养 脑梗死 昏迷 D-二聚体 胶质细胞源性神经营养因子 |
| 英文关键词: Hyperbaric oxygen Enteral nutrition Cerebral infarction Coma D-dimer Glial cell-derived neurotrophic factor |
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| 中文摘要: |
| 目的探讨高压氧联合早期肠内营养对脑梗死昏迷病人 41例的疗效。方法选取 2014年 1月至 2020年 1月湖北工业大学医院接诊的脑梗死昏迷病人 82例为研究对象，按照随机数字表法分成对照组(n=41例)、研究组(n=41例)。所有病人均给予神经内科常规治疗及高压氧治疗，在此基础上对照组实施延迟性肠内营养支持，研究组则实施早期肠内营养支持。比较两组格拉斯哥昏迷评分(GCS)、美国国立卫生研究院卒中量表(NIHSS)评分、营养指标、血清 D-二聚体(D-D)、胶质细胞源性神经营养因子(GDNF)水平及包括消化道应激性溃疡出血在内的并发症发生率。结果治疗 3周后，两组 GCS评分及血清 GDNF水平与治疗前相比升高(P<0.05)且研究组 GCS评分［(12.06±1.68)分比(10.83±1.49)分］及血清 GDNF水平［(402.51±26.83)ng/L比(356.42± 28.06)ng/L］均较对照组，高( P<0.05)；两组 NIHSS评分及血清 DD水平与治疗前相比均降低( P<0.05)，且研究组 NIHSS评分［(7.41±1.37)分比( 12.16±1.59)分］及血清 DD水平［(118.81±32.49)μg/L比( 167.32±46.85)μg/L］均较对照组低( P<0.05)；两组血红蛋白(Hb)、总蛋白(TP)、白蛋白(Alb)等营养指标与治疗前相比均降低(P<0.05)，但研究组 Hb、TP、Alb均较对照组高(P<0.05)。结论对脑梗死昏迷病人进行高压氧治疗联合早期肠内营养支持，可明显降低病人昏迷程度及神经功能缺损程度，显著改善机 |
| 英文摘要: |
| Objective To investigate the effect of hyperbaric oxygen combined with early enteral nutrition on 41 coma patients with cerebral infarction.Methods A total of 82 coma patients with cerebral infarction admitted to the Hospital of Hubei University of Tech-nology from January 2014 to January 2020 were selected as the research subjects and divided into the control group (n = 41 cases) andthe research group (n = 41 cases) according to the random number table method. All patients were given routine neurology treatmentand hyperbaric oxygen therapy. On this basis, the control group was given delayed enteral nutrition support, and the study group wasgiven early enteral nutrition support. The Glasgow Coma Scale (GCS) score, National Institutes of Health Stroke Scale (NIHSS) score,nutritional indicators, serum D-dimer (D-D), glial cell-derived neurotrophic factor (GDNF) levels and complication rates included bleed-ing from gastrointestinal stress ulcers.Results After 3 weeks of treatment, the GCS score and serum GDNF levels in the two groupswere increased compared with those before treatment (P < 0.05), and the GCS score [(12.06±1.68) points vs. (10.83±1.49) points] and serum GDNF level [(402.51 ± 26.83) ng/L vs. (356.42 ± 28.06) ng/L] in the study group were higher than those in the control group (P < 0.05). The NIHSS score and serum D-D levels in the two groups were lower than those before treatment (P < 0.05), and the NIHSS score [(7.41 ± 1.37) points vs. (12.16 ± 1.59) points] and serum DD level [(118.81 ± 32.49) μg/L vs. (167.32 ± 46.85) μg/L] in the study group were lower than those in the control group (P < 0.05). Nutritional indexes, such as hemoglobin (HB), total protein (TP) and albumin(ALB) in both groups were decreased compared with those before treatment (P < 0.05), while the HB, TP, ALB in the study group were higher than those in the control group (P < 0.05).Conclusions Hyperbaric oxygen therapy combined with early enteral nutrition sup-port for coma patients with cerebral infarction can significantly reduce the degree of coma and neurological deficits, significantly im-prove the malnutrition status of the body, effectively regulate the expression levels of serum D-D and GDNF, and greatly reduce the oc-currence of gastrointestinal stress ulcer bleeding and infection. |
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