Oh HyunSoo, Seo WhaSook
Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea.
JPEN J Parenter Enteral Nutr. 2006 Jul-Aug;30(4):321-30. doi: 10.1177/0148607106030004321.
Enteral nutrition support has been commonly used to improve nutrition status in acute stroke patients. The purpose of this study was to examine whether significant alterations in fluid and serum Na+ and K+ levels due to nasogastric tube feeding depended on patient age.
This study was conducted by retrospective review of the medical records of tube-fed patients with acute brain infarction who had been hospitalized in a university hospital.
Rates of overhydration were high before tube feeding in both elderly and nonelderly stroke patients. This overhydration rate became more prevalent after iso-osmolal tube feeding in the elderly but decreased somewhat in the nonelderly subjects, and this difference in fluid balance after tube feeding between the elderly and nonelderly was statistically significant. Contrary to fluid balance, serum Na+ and K+ concentrations were no different in the elderly and nonelderly patients after tube feeding.
Although the results showed that overhydration state was prominent after tube feeding in the elderly, it appeared that there was a very mild clinical impact because the osmolality and serum sodium were not changed in this group. However, more attention to the maintenance of fluid balance in the elderly tube-fed stroke patients is needed because elderly patients have great difficulty in maintaining a normal fluid balance.
肠内营养支持已普遍用于改善急性脑卒中患者的营养状况。本研究旨在探讨鼻饲引起的液体及血清钠和钾水平的显著变化是否取决于患者年龄。
本研究通过回顾性分析一所大学医院收治的急性脑梗死鼻饲患者的病历进行。
老年和非老年脑卒中患者在鼻饲前水过多发生率均较高。等渗鼻饲后,老年患者水过多发生率更为普遍,而非老年患者有所下降,老年和非老年患者鼻饲后液体平衡的这种差异具有统计学意义。与液体平衡相反,鼻饲后老年和非老年患者的血清钠和钾浓度无差异。
虽然结果显示老年患者鼻饲后水过多状态较为突出,但该组渗透压和血清钠未改变,似乎临床影响非常轻微。然而,由于老年患者维持正常液体平衡有很大困难,因此需要更加关注老年鼻饲脑卒中患者的液体平衡维持。