| BackgroundMalnutrition is an independent risk factor affecting the prognosis of stroke patients,and timely nutritional support can effectively promote the rehabilitation of stroke patients.At present,the timing of nutritional support is still controversial.Therefore,research on nutritional support at different timings is of great significance.ObjectiveThis study explores the potential impact of the timing of enteral nutritional support on nutritional status,neurological rehabilitation,and clinical outcomes in patients with acute stroke,and provides reliable data support and theoretical basis for early enteral nutritional support for patients with acute stroke in the future.MethodsIn this study,a retrospective data analysis method was used to select 1021 stroke patients who were admitted to a department of neurology in a top three hospital in Foshan from January 2015 to December 2016.According to the inclusion and exclusion criteria,99 cases were finally included as the research object.According to the start time of enteral nutrition support,it was divided into 24h group(within 24h),48h group(within 24-48h),and 7d(including 7d)after admission.The contents of collected medical records are:basic patient information,nutritional risk screening score,GCS score,nutrition indicators(Serum albumin(Alb),serum prealbumin(PA),hemoglobin(Hb),neurological score,clinical outcome,etc.Results1.A total of 99 patients were included in the study,including 35 patients in the 24h group,-32 patients in the 48h group,and 32 patients in the 7d group.There were no statistically significant differences in stroke type,gender,age composition and other factors among the three groups of patients at admission(P>0.05),which were comparable.2.Nutritional status indicators of the three groups of patients:① On the first day of admission,the nutritional risk assessment and nutritional indexes of the three groups of patients were not statistically different(P>0.05).② On the 14th day of admission,the nutritional indicators of the three groups were compared:the nutritional status of the patients in the 24h group was not significantly different from that in the 48h group(P>0.05);The patients in the 24h group were better than those in the 7d group after admission,and the difference was statistically significant(P<0.01);The patients in the 48h group were better than those in the 7d group,and the difference was statistically significant(P<0.05).3.Neurological function(NIHSS score)of three groups of patients:①On the first day of admission,there was no statistical difference between the three groups of patients(P>0.05).②At 14 days of admission,the NIHSS scores of patients in the 24h group were lower than those in the 48h and 7d groups(P<0.01).The nervous function 24h group shows the best improvement.The NIHSS score of patients in the 48h group was lower than that in the group after 7d(P<0.05).4.Clinical outcomes of the three groups of patients:Compared with the 48h group(P<0.05)and the group after 7 days(P<0.01),the incidence of complications in 48h group was decreased and the difference was statistically significant;The incidence of complications in the 48h group was lower than that in the group after 7d(P<0.05);Patients in the 24h group were hospitalized for less than the 48h group(P<0.05),and the patients in the group were the longest in bed after 7d;Among the complications,the incidence of urinary tract infections and respiratory tract infections was mostly,and the patients in the group after 7 days were higher than those in the 48h group,and the incidence of respiratory infections was the lowest in the 24h group.ConclusionsThis study found that early enteral nutrition support for patients with acute stroke can effectively improve their nutritional status,promote neurological recovery,improve clinical outcomes,and improve their overall prognosis.Enteral nutrition support is started within 24 hours after admission,and the improvement of prognosis for stroke patients better than within 48 hours or 7 days after admission.Because this study is a retrospective study and the sample size is small,there may be other undiscovered or corrected bias factors.Therefore,the research results need further analysis and verification. |
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