中国典型病例大全

目的 探讨重症脑卒中伴营养不良风险患者开展基于营养风险评估的个性化营养干预的实施效果。方法 选取2022年7月—2024年2月南宁市第八人民医院收治的60例重症脑卒中伴营养不良风险患者，按照随机数字法分为对照组和观察组，各30例。对照组实施常规营养干预，观察组实施基于营养风险评估的个性化营养干预；比较两组的营养指标水平、生化指标、并发症发生率、疾病预后指标。结果 干预后，两组血清总蛋白（total protein,TP）、血清白蛋白（albumin,ALB）、血红蛋白（hemoglobin,HGB）均升高，且观察组高于对照组（P<0.05）；干预前后，两组肌酐（serum creatinine,Scr）、尿素氮（blood urea nitrogen,BUN）水平对比，无统计学差异（P>0.05）；与对照组比，观察组并发症发生率低（P<0.05）；干预后，两组美国国立卫生研究院卒中量表（National Institutes of Health stroke scale,NIHSS）评分均降低（P<0.05），但组间比较，无统计学差异（P>0.05），相较于对照组，观察组格拉斯哥昏迷量表（Glasgow coma scale,GCS）评分高，住院时间短（P<0.05）。结论 对于伴有营养不良的重症脑卒中患者实施基于营养风险评估的个性化营养干预，可以及时筛查营养不良并指导开展营养支持，改善机体营养状况，防止肺部感染等并发症，从而实现促进患者康复、改善预后的目的，值得推广。

Objective To explore the effect of individualized nutritional intervention based on nutritional risk assessment in patients with severe stroke and malnutrition risk. Methods From July 2022 to February 2024, 60patients with severe stroke and malnutrition risk admitted to Guangxi Nanning Eighth People's Hospital were selected and randomly divided into control group and observation group, with 30 cases in each group. The control group received routine nutrition intervention, while the observation group received personalized nutrition intervention based on nutritional risk assessment. The nutritional index level, biochemical index, complication rate and disease prognosis index of the two groups were compared. Results After the intervention, serum total protein(TP), serum albumin(ALB)and hemoglobin(HGB)in both groups increased, and the observation group was higher than the control group(P<0.05). Before and after the intervention, there was no statistical difference in serum creatinine(Scr)and blood urea nitrogen(BUN)between the two groups(P>0.05).Compared with the control group, the incidence of complications in the observation group was lower(P<0.05).After the intervention, the scores of National Institutes of Health Stroke Scale(NIHSS)in both groups decreased(P<0.05), but there was no statistical difference between the two groups(P>0.05). Compared with the control group, the scores of Glasgow coma scale(GCS)in the observation group were higher and the hospitalization time was shorter( P<0.05). Conclusion Individualized nutritional intervention based on nutritional risk assessment can timely screen malnutrition and guide nutritional support, improve the nutritional status of the body and prevent complications such as lung infection, so as to achieve the purpose of promoting patients' rehabilitation and improving prognosis, which is worth popularizing.