Effect Of Intermittent Oro-esophageal Tube Feeding On Functional Recovery Of Patients With Severe Head Injury

Objective:The patients with severe head injury have complicated conditions,and tracheotomy is used to save life,which brings secondary injuries to the patients.Patients need to be given more energy during the recovery process and shorten the indwelling time of the air cut cannula,which is conducive to the patient’s disease control.This study retrospectively analyzed the therapeutic effects of intermittent oral to esophageal tube feeding(IOE)and nasal feeding tube feeding(NGT)on patients with severe head injury complicated with tracheotom,so as to provide clinical experience and optimize the treatment of patients.Methods:This retrospective study was based on case data and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University.Ninety-eight patients with severe craniocerebral injury complicated with tracheotom treated in the Department of Rehabilitation Medicine of the First Affiliated Hospital of Zhengzhou University from June 2019 to December 2020 were included in this study.According to the different nutritional mode of patients,the screening group was divided into observation group(IOE group)and control group(NGT group).During treatment,patients in both groups were routinely given nutritional nerve,anti-infection,physical factor therapy,acupuncture and moxibustion,exercise therapy and other comprehensive rehabilitation therapy.Patients in the observation group began to receive nutritional support by intermittent catheterization with IOE tube after admission and evaluation,regularly eat food at three meals every day,and regularly supplement water and juice,etc.The control group continued to use the original nasogastric tube for continuous catheterization for nutritional support after admission.By recording and comparing the nutritional status and Glasgow Coma Scale(GCS)score of patients in the two groups at admission and at(28±3)days after treatment,during the treatment,the indwelling time,extubation rate of the tracheotom tube cannula and complications were compared.Results:The basic data of the two groups were compared before treatment.Compared with nutritional indexes at the time of admission,there were differences between 2 groups before and after treatment(P>0.05),the serum indexes(hemoglobin,albumin,prealbumin)and body mass index of observation group were higher than those of control group at(28±3)days after treatment,the differences were statistically significant(P<0.05);There was no significant difference between the observation group and the control group in some complications(P>0.05),but the overall incidence of complications was lower than the control group,the difference was statistically significant(P<0.05).The indwelling time of tracheotom tube in the observation group was shorter than that in the control group,and the extubation rate was significantly higher than that in the control group,with statistically significant differences(P<0.01).The GCS score of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with NGT,IOE can effectively improve the nutritional status of patients with severe head injury combined with tracheotomy,reduce the occurrence of complications,shorten the duration of tracheotomy catheter indplacement,improve the extubation rate,and possibly improve the level of consciousness of patients,contributing to a faster return to family and society.