早期或晚期肠内营养对急性重症脑梗死患者内分泌功能的影响

发布时间：2018-04-27 05:26

本文选题：脑梗死 + 早期肠内营养　；参考：《南昌大学》2013年硕士论文

【摘要】：目的：通过本课题的研究，，观察早期肠内营养（24-48小时内）（EEF)或晚期肠内营养（DEF）（48小时-5天）对急性脑梗死患者的内分泌功能影响。以及内分泌功能是否会影响急性脑梗死患者的预后，进而阐明不同时期的肠内营养支持的激素水平对急性重症脑梗死患者临床转归的影响。方法：①这是项非盲的随机对照研究，完成急性重症脑梗死患者的收集，根据排除标准确定入选患者。严重程度通过NIHSS预测，生存率通过急性生理学和慢性健康状况评估。②34例患者给予早期营养组（24-48h内）和35例患者给予晚期营养组（48h-5天），并在入院时和入院后第6天、第12天监测并记录血浆TSH、FT3、FT4、皮质醇、睾酮水平。③完成不同营养组各激素水平的对比分析。④观察各激素水平变化特点后，评价早期和晚期肠内营养在急性重症脑梗死患者中对激素水平浓度变化的影响。结果：TSH、FT3、FT4、睾酮（男性患者）浓度在早期营养组和晚期营养组的病人中都出现刚入院的第一天下降，但在晚期营养组中比早期营养组下降的更低(P0.05)，皮质醇浓度在晚期营养组明显升高(P0.05)。在早期营养组中发现激素浓度的改变更小(P0.05)。结论：早期肠内营养（EEF）对急性重症脑梗死患者内分泌激素水平更有益处。减轻患者的炎症代谢反应，有益于改善患者预后。
[Abstract]:Objective: to investigate the effects of early enteral nutrition (EPN) or late enteral nutrition (DEF) on the endocrine function of patients with acute cerebral infarction (ACI) within 24-48 hours (24-48 hours) or late enteral nutrition (DEF) for 48 hours-5 days. And whether endocrine function will affect the prognosis of patients with acute cerebral infarction, and then clarify the effect of enteral nutrition support hormone levels on the clinical outcome of patients with acute severe cerebral infarction. Methods: one was a non-blind randomized controlled study to collect patients with acute severe cerebral infarction and to determine the selected patients according to the exclusion criteria. Severity was predicted by NIHSS, survival rate was assessed by acute physiology and chronic health status. 234 patients were given early nutrition group for 24 to 48 hours) and 35 patients were given advanced nutrition group for 48 h-5 days and at admission and 6 days after admission. On the 12th day, the plasma levels of TSHT FT 3 FT 4, cortisol and testosterone were monitored and recorded. To evaluate the effect of early and late enteral nutrition on hormone levels in patients with acute severe cerebral infarction. Results: TSHFT3 FT4, testosterone (male patients) decreased on the first day of admission in both early and late nutrition groups. However, the concentration of cortisol in the late nutrition group was significantly higher than that in the early nutrition group, and the concentration of cortisol in the late nutrition group was significantly higher than that in the early nutrition group. In early nutrition group, the change of hormone concentration was smaller than that of P0.05. Conclusion: early enteral nutrition (EEF) is more beneficial to endocrine hormone level in patients with acute severe cerebral infarction. Reducing the inflammatory metabolic response is beneficial to improve the prognosis of patients.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

【引证文献】