Analysis On The Intervention Effect Of Enteral Nutrition On Patients With Severe Stroke

Stroke, which is a commom chronic disease in clinical, has high incidence rate, mortality rate and mutilation rate on top of all the disease. The incidence of stroke is 219 per 100 thousands and the rate of deformity is 83%. For a dozen years, with the acceleration of the aging population and lifestyle changes, stroke has become one of the major public health problem. In particular, the prognosis of patients with severe stroke caused by illness and disability, will not only affect the quality of life of patients, but also to the family and society a huge financial burden. Severe Stroke patients with seriously brain lesion, disturbance of consciousness and other factors leading the patients can not take food. Large consumption of nutrients and decreased immunity result in dying from a variety of complications caused by malnutrition for severe stroke patients. However, the effective nutritional intervention can improve the nutritional status of patients, reduce complications caused by malnutrition, be helpful to the prognosis recovery of patients with severe stroke, and reduce adverse outcomes.Objective:We used randomized controllde trilasd and offered different enteral nutrition support for stroke patients,discussing the effect of nutrition support on clinical outcome,immune function and nutriton function.Comparison of different preparation on nutrition intervention in patientd with stroke effects,finding the best nutrition for stroke patients in clinical intervention, the establishiment of effective clinical nutritional support with severe stroke.Methods: In a randomized controlled trial design, 92 patients in the department of NCU in the 1St hospital of clinical medicine of Jilin University were selected. There are three groups in the trial according voluntary principles.32 patients were included the control group,30 patients were included the intervention group1 and 30 patients were included the intervention group2.All the patients received naso-gastric nutrition within 72 hours of admission.The control group received feeding supervised by homogenized diet, the intervention group1 received the sole application of the entire protein-based enteral nutrition preparations, the intervention group2 received the application of the generic peptide-based enteral nutrition preparation and then gradually the dietary-fiber type entire protein-based enteral nutrition preparations.General state of health including patient's age,gender,history of past and cuttent illness,initial temperature,initial blood pressure, midarmcircumference (MAC), decubitus risk score,Glasgow scores of the three groups were detected on the day of before and after intervention.To observed the nutrition and clinical status including blood biochemistry (GLU,SC,BUN), bloodion(Na+, K+, Ca2+), totalprotein (TP), pre-albumin (PA), transferrinprotein(TFP),retinol-bindingprotein(RBP),vitaminC(Vc)on the day of before and after intervention,and infective complications and lymphocyte perecentage (LP)of the three groups were also compared.Results:All the general states of health and nutrtion and clinical status of three groups had no significantly differences(P>0.05).After intervention,comparison among three groups the levels of glucose, SC, BUN and electrolytes had no significantly differences(P>0.05). The levels of LP in intervention-2 was significantly higher than control group after pairwise comparison(P<0.05).The levels of TP,RBP and Vc had no significantly differences among three groups(P>0.05).The levels of PA and TFB had significantly differences among the groups(P<0.05),after pairwise comparison,the levels of PA in intervention-2 had significantly difference among the groups(P<0.05) and the levels of TFB in control group had significantly difference among the groups(P<0.05).The comparison of before and after intervention in three groups,the levels of BUN after intervention was significantly higher than before in control group(P<0.05),and the levels of TFB,PA were significantly lower than before in control group(P<0.05).In intervention-1,the levels of glucose,BUN,PA,TFB and RBP after intervention were significantly higher than before(P<0.05),but others had on significantly differences after intervention(P>0.05).In intervention-2,the levels of glucose,LP,TP,PA,TFB and RBP after intervention were significantly higher than before(P<0.05).The incidence of infective complications had significantly differences among the groups(χ2=7.097,P=0.029). After pairwise comparison,α=0.017, the incidence of infective complications in intervention-1 groups had no significantly differences to control group(χ2=4.089,P=0.043), the incidence of infective complications in intervention-2 groups was significantly lower than control group(χ2=6.399,P=0.011).Conclusion: 1.The application of the generic peptide-based enteral nutrition preparation and then gradually the dietary-fiber type entire protein-based enteral nutrition preparations on severe stroke patients is the best of the enteral nutritions we used in our study. 2.After intervention, the levels of PA, TFB, RBP were significantly higher than before the intervention in intervention-1 group, the levels of TP, PA, TFB, RBP were significantly higher than before in intervention-2 group, the levels of PA, TFB were significantly lower than before in control group. 3.After intervention, the levels of glucose was significantly higher than before in intervention-1 group and intervention-2 group. 4.After intervention, the levels of BUN was significantly higher than before in control group and intervention-1 group. 5.After intervention, the levels of LP was significantly higher than before in intervention-2 group. 6. After intervention, the incidence of infective complications had significantly differences among the groups. The incidence of infective complications in intervention-2 groups was significantly lower than control group.