Clinical Study Of Enteral Nutrition In Different Periods After Acute Stroke

Objective:We offered early enteral nutrition support for dysphasic patients after acutestroke，and analyzed the incidence of malnutrition and the change of nutrition state．Itis discussed that the effect of nutrition support on immune function,the improvementof clinical nerve function and the incidence of infective complication neurologicaldeficit rehabilitation change.Methods:The dysphagia patients after acute stroke were evaluated by bedside testing．Thepatients that exceeded3rd grades were given enteral nutrition．They were randomlydivided into study group and control group．The patients of study group receivedenteral nutrition by gastric tube on the1day after acute stroke，and the control groupgot gastric tube on the4day．Each group was given the same energy perkilogram(25～30kcal/Kg*d)．We observed the incidence of immune function，thechange of nutrition state，the incidence of malnutrition，electrolyte disturbances，thepercentage of infection，the complication change the neurological deficit by NIHSSStroke scale and the length of nasogastric feeding，the total hospitalization expenses.Results:1.113patients were enrolled as research subjects．59cases were in the studygroup and54cases were in the control group．The gender，age，hypertension，diabetes， and NIHSS score were no significant difference between twogroups(P<0．05)． 2. The immune targets were no significantly different between the two groups(P>0．05)．Though the TLC，IgA，IgG，IgM in two groups decreased till14d，therewas significantly difference between the two groups.3.After admission，the serum level of ALB，STP，Hb，RBC in the control groupcontinued to deteriorate．There was less decline of both ALB，STP and Hb in studygroup. And there was significantly difference between the two groups at14d(P<0．05)．4. We observed the percentage of electrolyte disturbances in each group，whichshowed that the abnormal of both the blood sodium and blood potassium in the studygroup is significantly lower than that in the control group at14d,and the totalincidence of electrolyte disturbances is also lower(P<0．05).5. During hospital，the total infection，including pulmonary infection，urinarytract infection，enteric infection and bedsore incidence in the study group was27.1%，while in the control group it was44.4%，The total infection incidence in the studygroup was significantly lower than that in the control group(P<0．05)．6. There are less Cushing uler happened in study group．The total number of thestudy group is4(6.7%)，and the control group is10（18.5%）,between which there wassignificantly difference.7. NIHSS scores in the study group were separately16.63±3.19、12.02±4.01、7.55±3.31at ld，14d，28d，while they were17.12±3.56、14.92±3.01、10.77±3.32in the control group．The NIHSS scores in the study group significantly better thanthat in the control group at28d(P<0．05)．8. The length of nasogastric feeding and hospital stays，the same as thehospitalization expenses of study group was significantly lower than that of thecontrol group.Conclusion：Among the dysphagia patients after acute stroke，enteral nutrition support couldenhance body immune capacity，improve the low serum protein level，promote therecovery of neurological deficit and reduce the cost of hospitalization expenses.