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目的：研究早期肠内营养（EEN）对重症脑出血患者免疫功能和预后的影响。方法：选取2013 年1 月至2015年3 月间我院收治的重症脑出血患者161 例，依据随机数字表法分为对照组(n=77)和观察组（n=84），观察组患者入院12h~24h 内予以肠内营养乳剂支持，对照组患者予普通鼻饲流食。所有患者于治疗前及治疗后采用GCS 评估患者意识情况，检测血Alb、TP、PA、IgG、IgM、 IgA、CD4+T 细胞、CD8+T 细胞及CD4+/CD8+水平，并观察治疗后患者并发症的发生率。结果：治疗后观察组Alb、TP、PA 水平均显著高于对照组（均P<0.05）；治疗后观察组IgG、IgM、IgA、CD4+T 细胞、CD4+/CD8+水平均显著高于同期对照组，CD8+T细胞显著低于同期对照组（均P<0.05）；治疗后观察组GCS 评分显著高于对照组（P<0.05）；治疗后观察组患者肺部感染率，消化道症状发生率略低于对照组，但差异均无统计学意义（均P>0.05）。结论：重症脑出血患者予以EEN 治疗可明显改善其营养状况，有助于神经系统功能和免疫功能的恢复，改善预后，值得临床推广应用。

英文摘要:

Objective:To study the effect of early enteral nutrition (EEN) on the immune function and prognosis in patients with severe cerebral hemorrhage.Methods:A total of 161 patients with severe cerebral hemorrhage, who were admitted to Haikou Affiliated Hospital of Xiangya Medical College of Central South University fromJanuary 2013 to March 2015, were selected and randomly divided into control group (n=77) and observation group (n=84). The patients in the observation group were given enteral nutritional emulsion support within 12 h~24 h after admission, the patients in the control group, ordinary nasogastric liquid diet. The consciousness of all the patients was evaluated by GCS before and after treatment; the levels of Alb, TP, PA, IgG, IgM, IgA, CD4+T cells, CD8+T cells and CD4+/CD8+ of blood, were detected. The incidence of complication of patients after treatment was observed.Results:After treatment ,the levels of TP, PA and Alb in the observation group were significantly higher than those in the control group (P<0.05); the levels of IgG, IgA, IgM, CD4+T cells and CD4+/CD8+ in the observation group were significantly higher than those in the control group, and the level of CD8+T cells was significantly lower than that in the control group during the same period (P<0.05); the GCS score of the observation group was significantly higher than that in the control group(P<0.05); the incidence of pulmonary infection and incidence of symptoms of digestive tract in the observation group were slightly lower than those in the control group, but the difference had no significance(P>0. 05).Conclusion:EEN treatment can significantly improve the nutritional status and prognosis of patients with severe cerebral hemorrhage, and contribute to the recovery of neurological function and immune function, which is worthy of clinical popularization and application.

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