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目的对急性脑梗死合并有吞咽障碍的患者在发病早期进行营养评估,并进行营养干预,分析不同营养干预方法对预后的影响。方法采用《营养风险筛查2002》(NRS2002)对88例伴有吞咽障碍的急性脑梗死患者在入院时进行营养筛查;根据患者意愿分为鼻饲营养干预组及口服+静脉营养干预组。结果 88例患者入院时NRS2002评分平均(3.40±1.16)分,其中64.8%患者NRS2002评分≥3分。52例患者早期(入院24h内)鼻饲行胃肠内营养干预,36例患者拒绝鼻饲,给予口服及静脉营养干预,干预后患者血浆白蛋白及前白蛋白较干预前均有提升,但口服+静脉营养干预组住院时间、卒中相关性肺炎发生率均较鼻饲组高。结论急性脑梗死伴吞咽障碍患者营养风险高,尽早实施营养干预可减少卒中相关肺炎的发生率,减少患者住院时间,改善患者预后。
Objective To assess the nutritional status of patients with acute cerebral infarction complicated with swallowing disorders at the early stage of their illness and conduct nutritional interventions to analyze the impact of different nutritional interventions on prognosis. Methods Nutritional Risk Screening 2002 (NRS 2002) was used to screen 88 patients with acute cerebral infarction with swallowing disorder on admission. The patients were divided into nasal feeding intervention group and oral + intravenous nutrition intervention group according to patients’ wishes. Results 88 cases of patients admitted to hospital NRS2002 score average (3.40 ± 1.16) points, of which 64.8% of patients with NRS2002 score ≥ 3 points. In the 52 cases of early nasal feeding (within 24h of admission), gastrointestinal nutrition intervention was given to nasal feeding, 36 cases refused nasal feeding, oral and intravenous nutrition intervention was given, serum albumin and prealbumin increased after intervention, but oral + Intravenous nutrition intervention group hospitalization time, the incidence of stroke-related pneumonia were higher than the nasal feeding group. Conclusion The nutritional risk of patients with acute cerebral infarction and swallowing disorders is high. Implementing nutritional intervention as soon as possible can reduce the incidence of stroke-related pneumonia, reduce hospitalization time and improve prognosis.