目的 构建颅内动脉瘤性蛛网膜下腔出血患者围手术期肠内营养管理方案,探讨肠内营养方案对改善颅内动脉瘤 性蛛网膜下腔出血患者营养状况及病情的正性作用。 方法 选取安徽医科大学第一附属医院于 2020 年 1 月至 2024 年 12 月住 院的颅内动脉瘤性蛛网膜下腔出血患者 96 例。 采用区组结合随机数字表法将调查对象分为试验组和对照组,每组 48 例。 对 照组采用常规治疗及护理,试验组在对照组的基础上采用基于循证+专家咨询的方法构建的肠内营养方案。 结果 构建的颅内 动脉瘤性蛛网膜下腔出血围手术期患者肠内营养方案共包括 4 个一级指标、12 个二级指标、31 个三级指标,证据等级均为 B 级及以上。 2 例患者(试验组、对照组各 1 例) 因术后病情变化自动出院,共有 94 例患者完成试验,年龄 35 ~ 84 岁,平均 (50. 66±7. 95)岁,男性 30 例(31. 91%),女性 64 例(68. 09%),两组患者基线资料差异无统计学意义(P>0. 05);肠内营养方案 实施后,试验组的营养风险筛查 2002 得分显著低于对照组,试验组患者的营养指标(总蛋白、白蛋白、血红蛋白)水平显著高 于对照组,试验组患者喂养不耐受发生率显著低于对照组,营养达标情况均显著高于对照组,试验组患者急性生理学及慢性 健康状况评分系统 Ⅱ(APACHE Ⅱ )评分比较显著低于对照组,差异均有统计学意义(P<0. 05)。 结论 构建颅内动脉瘤性蛛 网膜下腔出血患者围手术期肠内营养方案有利于改善患者营养指标、降低围手术期营养风险、减少喂养不耐受发生、提高营 养达标状况及改善患者病情。

Objective To construct a perioperative enteral nutrition management programme for patients with intracranial aneurysml subarachnoid hemorrhage and to explore the positive effect of enteral nutrition programme on improving the nutritional status and condition of patients with intracranial aneurysml subarachnoid hemorrhage. Method A total of 96 patients with intracranial aneurysm rupture subarachnoid hemorrhage admitted to the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2024 were selected by convenient sampling. As the investigation objects of this study the investigation objects were divided into intervention group and control group by block group combined with random number table method with 48 persons in each group. The control group received conventional treatment and nursing and the intervention group received enteral nutrition on the basis of the control group. Result The constructed enteral nutrition programme for perioperative patients with intracranial aneurysml subarachnoid hemorrhage included a total of 4 primary indicators 12 secondary indicators and 31 tertiary indicators all with a grade of evidence of B and above. 2 patients one in the intervention group and one in the control group were automatically discharged from the hospital due to postoperative changes in their condition and a total of 94 patients completed the trial with ages ranging from 35 to 84 years old averaging 50. 66±7. 95 years old 30 31. 91% males and 64 68. 09% females and there was no difference in the baseline data of the patients in the two groups P>0. 05 after the implementation of enteral nutritional regimen the intervention the nutritional risk screening 2002 score of the intervention group was significantly lower than that of the control group the nutritional indicators total protein albumin hemoglobin of the patients in the intervention group were significantly higher than that of the control group the feeding intolerance of the patients in the intervention group was significantly lower than that of the control group the nutritional attainment of the standard was significantly higher than that of the control group and the results of the APACHE Ⅱ score of the patients in the intervention group were comparatively significantly lower than that of the control group and the differences were all statistically significant P < 0. 05 . Conclusion The construction of a perioperative enteral nutrition programme for patients with intracranial aneurysml subarachnoid hemorrhage is conducive to improving patients nutritional indicators reducing perioperative nutritional risk reducing the occurrence of feeding intolerance improving nutritional compliance and improving patients disease development.