阿替普酶联合早期肠内营养制剂用于急性脑梗死患者的效果观察OACSTPCD

OBJECTIVE:To probe into the clinical effect of alteplase combined with early enteral nutrition preparation on patients with acute cerebral infarction.METHODS:A total of 98 patients with acute cerebral infarction admitted into Hai'an People's Hospital Affiliated to Nantong University from Jan.2021 to Jun.2023 were selected to be divided into observation group and control group via random number table method,with 49 cases in each group.The control group was given early routine self-made nasal feeding liquid diet after alteplase thrombolytic therapy,while the observation group received early nasal feeding enteral nutrition preparation after alteplase thrombolytic therapy.The clinical efficacy,nutritional status indicators[prealbumin(PA),albumin(ALB)and total protein(TP)],neurological function[National Institutes of Health Stroke Scale(NIHSS)],neuro-impairment markers levels[serum neuron-specific enolase(NSE),S100 calcium binding protein β(S100β)and brain-derived neurotrophic factor(BDNF)],Glasgow outcome scores(GOS),intracranial hemorrhage rate and hospitalization indicators were compared between two groups.RESULTS:After treatment,the total effective rate of the observation group was significantly higher than that of control group[83.7%(41/49)vs.65.3%(32/49)],with statistically significant difference(χ2=4.353,P<0.05).After treatment,the PA level(t=12.593,P<0.001),ALB level(t=4.583,P<0.001),TP level(t=4.497,P<0.001),BDNF level(t=4.619,P<0.01)and GOS score(t=4.342,P<0.001)of the observation group were higher than those of the control group,the NIHSS score(t=5.371,P<0.001),NSE level(t=4.342,P<0.001)and S100β(t=6.015,P<0.001)of the observation group were lower than those of the control group,the ICU stay(t=4.358,P<0.001)and hospital stay(t=6.509,P<0.001)of the observation group were shorter than those of control group,all of the above differences were statistically significant.One patient in the control group developed asymptomatic cerebral hemorrhage,while no patient in the observation group developed asymptomatic intracerebral hemorrhage,no symptomatic intracranial hemorrhage occurred in both groups;the difference in intracranial hemorrhage rates between two groups was not statistically significant(P>0.05).CONCLUSIONS:Alteplase combined with early enteral nutrition preparation has significant efficacy in reducing nerve injury in patients with acute cerebral infarction,which also helps to promote the improvement of patients'nutritional status and prognostic quality,with good clinical application value.