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

The effects of early enteral nutrition on intestinal flora, nutritional index and neurological function in patients with hypertensive cerebral hemorrhage

摘要:

目的 探讨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。方法 选取2017年1月—2019年12月浙江新安国际医院收治的高血压脑出血患者78例。依据随机数字表法随机分为观察组和对照组，每组39例。两组患者均于入院24 h内行开颅血肿清除术。对照组于术后1 d给予肠外营养治疗，观察组于术后1 d给予肠内营养支持治疗。两组疗程均为14 d。比较两组治疗前后肠道菌群、营养指标和神经功能的变化及并发症情况。结果 观察组治疗前后双歧杆菌、肠球菌、大肠杆菌的差值大于对照组（P <0.05）。观察组治疗前后血红蛋白、前白蛋白和白蛋白水平的差值大于对照组（P <0.05）。观察组治疗前后NIHSS评分的差值大于对照组（P <0.05）。两组肺部感染和电解质紊乱发生率比较，差异无统计学意义（P >0.05）；观察组应激性溃疡发生率低于对照组（P <0.05）。结论 早期肠内营养治疗高血压脑出血患者效果良好，可改善患者肠道菌群紊乱和营养状况，减轻神经功能缺损，并发症少。

关键词:高血压脑出血;早期肠内营养;肠道菌群;营养指标;神经功能

Abstract:

Objective To investigate the effects of early enteral nutrition on intestinal flora, nutritional index and neurological function in patients with hypertensive cerebral hemorrhage.Methods The 78 patients with hypertensive cerebral hemorrhage in our hospital from January 2017 to December 2019 were randomly divided into observation group (39 cases) and control group (39 cases). All patients in both groups were performed surgical hematoma evacuation within 24 hours after admission. The control group was given parenteral nutrition on the first day after operation, and the observation group was given enteral nutrition on the first day after operation. The course of treatment in both groups was 14 days. The changes of intestinal flora, nutritional index, and neurological function before and after treatment as well as complications were compared between the two groups.Results The differences of Bifidobacterium, Enterococcus and Escherichia coli before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of hemoglobin, prealbumin and albumin levels before and after treatment in the observation group were higher than those in the control group (P < 0.05). The National Institutes of Health Stroke Scale (NIHSS) score before and after treatment was higher in the observation group than that in the control group (P < 0.05). The incidence of pulmonary infection and electrolyte disturbance was not different between the two groups (P > 0.05), while the incidence of stress ulcer in the observation group was lower than that in the control group (P < 0.05).Conclusions Early enteral nutrition demonstrates a good curative effect in hypertensive cerebral hemorrhage patients. It can improve the disturbance of intestinal flora, nutritional status of the patients, and neurological deficit with less complications.

Key words:early enteral nutrition;hypertensive intracerebral hemorrhage;intestinal flora;nutritional indicators;neurological function