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急性中风患者不同喂养方式下营养状况指标的比较

Comparison of nutritional status indicators according to feeding methods in patients with acute stroke.

作者信息

Kim Sanghee, Byeon Youngsoon

出版信息

Nutr Neurosci. 2014 Apr;17(3):138-44. doi: 10.1179/1476830513Y.0000000078. Epub 2013 Nov 26.

Abstract

BACKGROUND

Feeding methods for patients with acute stroke differ based on their ability to swallow; therefore, it is necessary to determine whether these methods deliver enough nourishment to these patients. Although nutrition could affect recovery from acute stroke, it is often overlooked. Indicators of nutritional status are important for the nutritional assessment of patients.

PURPOSE

The purpose of this study was to compare changes in nutritional indicators with various feeding methods in patients with acute stroke.

METHODS

Data on 261 patients with acute stroke who were admitted to a stroke unit in 2010 and met the inclusion criteria of the study were retrospectively analyzed. For comparative analysis, we investigated the participants' National Institutes of Health Stroke Scale score, feeding methods using the Modified Gugging Swallowing Screen, and indicators of nutritional status, such as body mass index, pre-albumin level, albumin level, total lymphocyte count, and total protein level. All nutritional indicators were compared at the time of admission to the stroke unit and at 7 days after admission.

RESULTS

At the time of admission, indicators of nutritional status were within normal ranges in all feeding groups (tube, dysphagia, and general diet). At 7 days after admission, pre-albumin (P = 0.003), albumin (P = 0.001), and total protein (P = 0.000) values in the tube feeding group were below the normal range, and the pre-albumin value and total lymphocyte count were below the normal range in the dysphagia diet group (P = 0.027). The values for all nutritional indicators were within normal limits in the general diet group.

CONCLUSIONS

Indicators of nutritional status change according to the swallowing ability of patients with acute stroke. At 7 days after admission to the stroke unit, patients with severe dysphagia had higher levels of indicators of malnutrition. Health care providers should consider whether the feeding method of each patient with stroke provides suitable nourishment. Additionally, it is important to know why these indicators vary based on swallowing abilities and what these patients require for adequate nutrition.

摘要

背景

急性中风患者的喂养方法因其吞咽能力而异;因此,有必要确定这些方法是否能为这些患者提供足够的营养。尽管营养状况会影响急性中风的恢复,但它常常被忽视。营养状况指标对于患者的营养评估很重要。

目的

本研究的目的是比较急性中风患者采用不同喂养方法时营养指标的变化。

方法

回顾性分析了2010年入住中风单元且符合本研究纳入标准的261例急性中风患者的数据。为进行比较分析,我们调查了参与者的美国国立卫生研究院卒中量表评分、使用改良古金吞咽筛查法的喂养方法以及营养状况指标,如体重指数、前白蛋白水平、白蛋白水平、总淋巴细胞计数和总蛋白水平。在入住中风单元时和入住后7天对所有营养指标进行了比较。

结果

入院时,所有喂养组(鼻饲、吞咽困难和正常饮食)的营养状况指标均在正常范围内。入院后7天,鼻饲组的前白蛋白(P = 0.003)、白蛋白(P = 0.001)和总蛋白(P = 0.000)值低于正常范围,吞咽困难饮食组的前白蛋白值和总淋巴细胞计数低于正常范围(P = 0.027)。正常饮食组的所有营养指标值均在正常范围内。

结论

急性中风患者的营养状况指标根据其吞咽能力而变化。入住中风单元7天后,严重吞咽困难的患者营养不良指标水平较高。医护人员应考虑每位中风患者的喂养方法是否能提供合适的营养。此外,了解这些指标为何因吞咽能力而异以及这些患者获得充足营养需要什么很重要。

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