复方阿嗪米特辅助早期鼻饲喂养降低急性脑血管病患者医院感染及胃肠道并发症的效果研究

发布时间：2018-02-04 08:11

本文关键词： 复方阿嗪米特肠溶片急性脑血管病早期鼻饲喂养胃肠道并发症医院感染临床价值　出处：《中华医院感染学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的观察复方阿嗪米特肠溶片辅助早期鼻饲喂养预防急性脑血管病患者医院感染及胃肠道并发症的效果,提高急性脑血管病患者治疗质量。方法选择2015年2月-2016年1月医院收治的急性脑血管病进食困难患者146例,随机分为对照组和观察组,每组73例,两组患者均采用早期鼻饲喂养及对症治疗方案治疗,观察组患者在此治疗基础上加用复方阿嗪米特肠溶片,两组患者均连续治疗3周为一个疗程;比较两组患者治疗前、后免疫功能指标变化、鼻饲喂养期间发生胃肠道并发症及医院感染情况。分析复方阿嗪米特肠溶片辅助鼻饲喂养的应用价值。结果两组患者治疗前免疫指标(血清免疫球蛋白(IgG、IgA、IgM)、T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+))比较差异无统计学意义,治疗一疗程后,两组患者IgG、IgA、IgM、CD3+、CD4+、CD4+/CD8+均较治疗前明显下降(P0.05),但治疗后观察组高于对照组(P0.05),CD8+、较治疗前升高,且观察组低于对照组(P0.05)。对照组患者鼻饲治疗期间共发生24例胃肠道并发症占32.88%,其中2例因严重的腹泻转为肠外营养,观察组患者发生10例胃肠道并发症占13.70%,未出现中转肠外营养病例,对照组患者鼻饲期间及鼻饲后一周内共发生医院感染8例占10.96%,观察组共发生3例占4.11%,观察组患者胃肠道并发症率及医院感染率明显低于对照组(P0.05)。结论复方阿嗪米特肠溶片改善鼻饲喂养急性脑血管病患者的胃肠功能,降低胃肠道并发症,促进营养成分的吸收,提高患者免疫能力,降低了患者医院感染的风险,具有较高的临床价值。
[Abstract]:Objective to observe the effect of compound azinomide enteric-coated tablets on the prevention of nosocomial infection and gastrointestinal complications in patients with acute cerebrovascular disease. Methods from February 2015 to January 2016, 146 patients with acute cerebrovascular disease who had difficulty eating were randomly divided into control group and observation group. 73 patients in each group were treated with early nasogastric feeding and symptomatic therapy. The patients in the observation group were treated with compound azinomide enteric-coated tablets on the basis of this treatment. The two groups were treated continuously for 3 weeks as a course of treatment. The changes of immune function before and after treatment were compared between the two groups. Gastrointestinal complications and nosocomial infection occurred during nasal feeding. The application value of compound azinomide enteric-coated tablets in nasal feeding was analyzed. Results the immune indexes (serum immunoglobulin) before treatment were analyzed in both groups. IgG. There was no significant difference in T lymphocyte subsets (CD3, CD _ 4, CD _ 8, CD _ 4 / CD _ 8) between the two groups. After one course of treatment, IgG was found in the two groups. The CD4 / CD8 ratio of CD4 / CD8 in IgA MCD3 was significantly lower than that before treatment, but it was higher in the observation group than that in the control group after treatment. Compared with before treatment, the observation group was lower than the control group (P 0.05). 24 cases of gastrointestinal complications occurred during nasal feeding in the control group (32.88% cases). Among them, 2 cases were converted to parenteral nutrition due to severe diarrhea, 10 cases of gastrointestinal complications occurred in the observation group (13.70%), and no cases of conversion to parenteral nutrition were found. Nosocomial infection occurred in 8 patients (10.96%) during nasal feeding and one week after nasal feeding in the control group, and 3 cases (4.11%) in the observation group. The rate of gastrointestinal complications and nosocomial infection in the observation group was significantly lower than that in the control group (P0.050.Conclusion compound azinomide enteric-coated tablets can improve the gastrointestinal function of patients with acute cerebrovascular disease fed by nasal feeding. It is of high clinical value to reduce gastrointestinal complications, promote the absorption of nutrition, improve the immune ability of patients and reduce the risk of nosocomial infection.
【作者单位】：河南科技大学第一附属医院制剂室;河南科技大学第一附属医院门诊药房;河南科技大学第一附属医院住院药房;
【分类号】：R743.3
【正文快照】： 急性脑血管病患者在急性期发生机体应激反应,各脏器处于高代谢状态,消耗的蛋白质远远高于正常体质,再者患者常出现昏迷、吞咽困难等无法进食,导致蛋白质摄入不足,各种营养成分如必需氨基酸、脂肪酸、微量元素等缺乏,整个机体的免疫功能出现特异性或非特异性障碍,抵御外来侵袭

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