r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2023-28-6-67-76r-n-j-506Research ArticleЛЕКЦИЯLECTUREАктуальные вопросы нутритивной поддержки пациентов с острым нарушением мозгового кровообращенияTopical issues of nutritional support for patients with acute cerebrovascular accidenthttps://orcid.org/0009-0004-5302-0061ЧупринаС. Е.СhuprinaS. E.

Воронеж

Voronezh

chuprinasveta@mail.ruhttps://orcid.org/0009-0003-8055-1979ЖигульскаяН. А.ZhigulskayaN. A.

Воронеж

Voronezh

n.zhigulskaya@gmail.comВоронежская областная клиническая больница № 1РоссияVoronezh Regional Clinical Hospital №1Russian Federation2023080120242866776Copyright © Чуприна С.Е., Жигульская Н.А., 20242024Чуприна С.Е., Жигульская Н.А.Сhuprina S.E., Zhigulskaya N.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/506

Частота встречаемости недостаточности питания у пациентов с острым нарушением мозгового кровообращения (ОНМК) варьирует в широких пределах и составляет 6,1–62%. Факторы риска недостаточности питания у пациентов с ОНМК многообразны и включают в себя тип и тяжесть инсульта, пол, возраст, наличие дисфагии, когнитивных нарушений, полисенсорной недостаточности, тяжелых коморбидных состояний, отсутствие достаточного ухода и проч. При этом как предшествовавшая, так и развившаяся в результате ОНМК недостаточность питания является причиной более длительного пребывания в стационаре, ухудшения функциональных результатов и увеличения показателей летальности. Метаболический ответ на стресс у пациентов с ОНМК представлен синдромом гиперметаболизма-гиперкатаболизма и является важнейшим компонентом системной воспалительной реакции, развитие и прогрессирование которой приводит к инфекционным осложнениям, полиорганной дисфункции, увеличению сроков госпитализации и повышению летальности. В настоящее время клиническое питание, или нутритивная поддержка (НП), рассматривается не только как процесс обеспечения организма энергией и пластическим материалом с целью профилактики и лечения недостаточности питания, но и как возможность воздействовать на структурно-функциональные и метаболические процессы с целью повышения адаптационных резервов организма, что необходимо для выздоровления и реабилитации пациентов. Целями настоящего обзора являются анализ современных научных данных о стратегиях клинического питания и разработка оптимального алгоритма действий для реализации НП в клинической практике при лечении и реабилитации пациентов с ОНМК.

The incidence of malnutrition in stroke patients varies widely and amounts to 6.1–62%. Risk factors for malnutrition in stroke patients are diverse and include the type and severity of stroke, gender, age, dysphagia, cognitive impairment, polysensory insufficiency, severe comorbid conditions, lack of adequate care, etc. At the same time, both the previous and the malnutrition that developed as a result of the stroke is the reason for a longer stay in the hospital, deterioration of functional results and an increase in mortality rates. The metabolic response to stress in stroke patients is represented by the hypermetabolism-hypercatabolism syndrome and is an essential component of the systemic inflammatory response, the development and progression of which leads to infectious complications, multiple organ dysfunction, increased hospitalization and increased mortality. Currently, clinical nutrition, or nutritional support (NS), is considered not only as a process of providing the body with energy and plastic material for the prevention and treatment of malnutrition, but also as an opportunity to influence structural, functional and metabolic processes in order to increase the adaptive reserves of the body, which is necessary for the recovery and rehabilitation of patients. The objectives of this review are the analysis of modern scientific data on clinical nutrition strategies and the development of an optimal algorithm of actions for the implementation of NS in clinical practice in the treatment and rehabilitation of stroke patients.

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The authors declare that there are no conflicts of interest present.