The Effects Of ?-3Fatty Acids Enteral Nutrition To Severe Neurosurgical Patients' Stress Status And Nutritional Metabolism

Objective:To observe the diffrence in effects between ?-3fatty acids enteral nutrition and traditional enteral nutrition in relieving stress status,improving nutritional metabolism and the changing tendencies of indexes to severe neurosurgical patients.Methods:1 The methods of choosing patientsTotal 40 patients from neurosurgery of Hebei Provincial People's Hospital in 2015 whose GCS scores between 3and 8 and age between 18 to 80 years old, are matched to 20 pairs in the rule which their age diffrence is no more than 5, the patients in each pair are randomly assigned to experimental group and control group, there are 20 patients in each group. In the early stage of severe condition, the experimental group was treated with ?-3fatty acids EN, the control group was treated with traditional EN. Both of groups are Measured the contents of CRP, Alb, PAb, TF in 5 times which is before the treatment,1day after treatment, 4, 7and14 days after treatment. The data of each index are contrasted between and within groups. There are none significant varieties in before treatment of the data of each index. All the patients don't have hepatic and kidney function obstacle, coronary heart disease, diabetes and feeding intolerance.2 The methods of processing the dataUsed SPSS17.0 to process all the data, 95% confidence level. Making comparisons of inter group non treatment factors such as ages, weight, sex composition and GCS scores, there are none significant varieties. Repeated measures analysis of variance in general linear model was used to discuss the difference between groups, within group, the interaction of the time and treatment factors. The simple effect of the time and the main effect within group were observed when the interaction between the treatment factor and the time was obvious. The four parameters have none differences between groups. Multivariate analysis of variance was adopted to discuss the difference between two groups on time horizon.3 Which results were been analyzedTo analyze the effect of time, treatment factors and the interaction between them.Results:1 The varieties of the data of each index within groupsCRP: Both of the two groups have significant varieties among different time-points. Each time-points have significant varieties in experimental group. And except the t2 and t3,each time points also have significant varieties in control group. Alb: All of the after-treatment time-points are lower than before-treatment time points in the two groups, and the data of 14 days after-treatment time-point is higher than 1day after-treatment time-point in experimental group, and there are none signifcant varieties among after-treatment time-points in control group. PAb: All of the after-treatment time-points are lower than before-treatment time points in the two groups, and there are none signifcant varieties among after-treatment time-points in the two groups. TF: All the after-treatment time-points are lower than the before-treatment time-point, and 4, 7, 14 days after-treatment time-points are lower than 1day after-treatment time-point. There are none significant varieties among 4, 7, 14 days after-treatment time-points.2 The varieties of the data of each index between groupsThere are visible differences between the two groups in the data of CRP,F=99.067,P=0.000<0.01. There are significant varieties between two groups in the earlier after-treatment time-points of the data of PAb and TF, PAb: F=4.437,P=0.042<0.05, TF: F=11.594, P=0.002<0.05. And in the later time-points there are significant varieties between two groups of the data of Alb, F=8.662,P=0.006<0.05.3 The changing tendencies of indexes of the two groupsBoth the two groups' s data rised first then slowlier went down, there are interaction between two factors and so there are significant variety between the two kinds of tendencies. The data of the Alb, PAb and TF were going down since the first time-point. There is significant variety between the two kinds of tendencies of Alb. And the tendencies are same between the two groups of PAb and TF.Conclusion:1 CRPThe changing tendency of stress status occurred acute, became more and more serious and then recoverd slowlier. The varieties between two groups and the interaction between two factors are obvious. The stress reaction of the experimental group is smaller than control group in the all time-points, and the speed of stess reaction's increasing of the experimental group is slower than the control group's. ?-3Fatty acids enteral nutrition can obviously relieve stress status.2 AlbThe nutritional status at 14 days after-treatment time-point is better than at 1 day after trauma in experimental group. The nutritional status in experimental group after trauma decreased slower and recoverd faster than in control group. In the later phase, the nutritional status of the experimental group is better than the control group's and the hepatic metabolism and reserve of the experimental group are also better than the control group's.3 PAbAs a sensitive index, the PAb decreased fast after trauma and basicly was in the platform stage after nutritional therapy. In the earlier stage, the negative nitrogen balance, liver function, the liver damage condition and the prognosis of the liver damage of the experimental group is better than the control group's. This variety is relative to that in the later stage the hepatic metabolism and reserve of the experimental group is better than the control group's.4 TFThe transferrin showed a downward trend and was in the platform stage after 4 days. The aerobic metabolism of the experimental group was in a larger proportion in the early stage and deceased the energy expenditure. This variety is relative to that in the later stage the experimental group's nutritional status was better than the control group's.5 The connection among Alb, PAb and TFIt is a process to develop for diseases which is affected by many factors such as the condition aggravation, the operation, the standard of care and so on. PAb and TF have none significant varieties at later time-points between two groups since other factors' effects became larger than before. With clinical significance of each index, we can explain the relationship between Alb and PAb of varieties between groups, and the relationship between Alb and TF of varieties between groups. Further test of correlation needs to be done to get the relevant value. But the three index's varieties between groups all have clinical significance.