| Objective:We offered early enteral nutrition support for dysphasic patients after acute stroke, analyzed the incidence of malnutrition and the change of nutrition state. It is discussed that the effect of nutrition support on immune function. We observed the improvement of clinical nerve function, the incidence of infective complication neurological deficit rehabilitation change.Methods:The dysphasic patients after acute stroke were evaluated by bedside testing. The patients that exceeded 3rd grades were given enteral nutrition. They were randomly divided into study group and control group. All the patients received enteral nutrition by gastric tube within 48 hours after acute stroke. The study group was given enteral nutrition formulas Fresubin 750 MCT, and the control group was given liquid diet prepared under the guidance of dieticians. Each group was given the same energy and same nitrogen per kilogram. We observed the change of nutrition state, the incidence of malnutrition, immune function, clinical effect and complication change the neurological deficit by NIHSS Stroke scale.Results:1 120 patients were enrolled as research subjects. 62 cases were in the study group and 58 cases were in the control group. The gender, age, stroke type, neurological deficit grades , and GCS score were no significant difference between two groups(P <0.05).2 After admission, the serum level of ALB, PA in the control group continued to deteriorate. The serum level of ALB, PA in the study group trended downward after admission, and they restored at 21d and improved significantly at 28d.There was significantly difference between the two groups at 28d .3 During hospital, the total infection incidence in the study group was 53.2%, while in the control group it was 72.4%; The total infection incidence in the study group was significantly lower than that in the control group (P <0.05).4 The immune targets were no significantly different between the two groups (P> 0.05). when the TLC, IgA, IgG, IgM in two groups are decreased, at 7d.The control group continued to decrease, while the study group restored near the admission level.5 After 28d,11 cases occurred abdominal distension,12 cases occurred diarrhea and vomiting in the study group, the control group are separately 13 cases, 16 cases. There was no significant difference between the two groups. 7 cases occurred constipation, in the study group, while l6 in the control group. The constipation incidence was significant between the two groups (P< 0.05).6 NIHSS scores in the study group were separately 14.42±2.62,12.23±2.53,8.84±2.23 at 1d,7d,28d,while they were 15.07±2.51,13.38±2.41,11.23±2.43 in the control group. The NIHSS scores in the study group significantly better than that in the control group at 28d(P <0.05).7 The clinical effect was based on the improvement of neurological deficit scores .Compared the clinical effect between two groups, 15 cases improved significantly, 30 cases improved 14 cases did not change in the study group. 6 cases improved significantly, 20 cases improved 28 cases did not change in the study group. The clinical effect in the study group was significantly better than that in the control group (P < 0.05).8 The hospitalization and nasal feeding time, infection duration in the study group were significantly lower than those in the control group. There were significant differences between the two groups(P < 0.05).Conclusion:1 Malnutrition is common in dysphasic patients after acute stroke and the nutritional status trends to deteriorate during hospital.2 Early enteral nutrition support could increase serum protein level, reduce the incidence of malnutrition, enhance body immune capacity and promote the recovery of neurological deficit.
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