| Objective:To investigate the effect of the combination of early enteral nutrition, supplementary parenteral nutrition and immune support on the postoperative hypertensive intracerebral hemorrhage patients. The indicators of nutritional state, infection, immune, neural function,social benefits and complications were checked.Methods:80 cases(44 males and 36 females, aged between 35 to 70, respectively) of patients with the postoperative hypertensive intracerebral hemorrhage were surveyed. All cases came from the department of Neurosurgery, Coal General Hospital of Datong city, Shanxi Province, June 2014 to June 2015. The patients were diagnosed following as the diagnostic criteria revised in the Fourth National Cerebrovascular Disease Academic Conference. All of these patients who were disturbance of consciousness when they were hospitalized and scored between 6 to 8 points in GCS can defined as acute severe cerebral hemorrhage.These patients were randomly divided into two groups including the control group(n=40)and the treated group(n=40). The age, gender, average weight, GCS score and operation way in patients of two groups had no significant difference and all patients were treated with the same drug except for different nutritional support. The effect of nutritional support in patients of two groups was observed by comparing the change of all indicators at the 1st and 14 th day after nutritional support. At the same time, the complications, such as gastric retention, diarrhea, vomiting and upper gastrointestinal bleeding, were observed.Results:1. The indicators of nutrition: The levels of triceps skinfold thickness, plasma albumin,prealbumin, plasma total protein and transferrin in patients of two groups had no statistically significant difference at the 1st day after nutritional support(P > 0.05),otherwise, the levels of hemoglobin, creatinine height index had significant difference(P <0.05). At 14 th day after nutritional support, compared with the control group, the triceps skinfold thickness of patients in the treated group was significantly thicker(P < 0.05) and the levels of plasma albumin, hemoglobin were significantly higher(P < 0.05) while there were no difference of prealbumin, creatinine height index, plasma total protein and transferrin between patients in two groups(P > 0.05).2. The indicators of infection: At the 1st day after nutritional support, there was no difference between patients of two groups in the levels of procalcitonin, white blood cells,eosinophilic granulocyte and high-sensitivity CRP(P > 0.05). After adopting nutritional support for 14 days, the levels of those indicators in patients of the treated group were significantly lower than that of the control group(P < 0.05).3. The indicators of immune: There was no statistically significant difference between two groups in the levels of Ig A, Ig G and Ig M(P > 0.05). Except for Ig A and Ig G, the levels of Ig M and peripheral circulating lymphocyte count in patients of the treated group were significantly increased compared with the patients in control group after nutritional supported for 14 days(P < 0.05).4. The results of nutrition scale assessment: After the 1st day of nutritional support,MNA evaluation results in patients of two groups showed no difference(P > 0.05). And after 14 days treating, MNA evaluation results in patients of the treated group showed an significant increasing rather than that of the control group(P < 0.05).5. The results of NIHSS score: The 1st day's result showed that there was no difference between two groups in the NIHSS score(P > 0.05). Otherwise, the 14 th day's result showed that the NIHSS score of patients in treated group was lower than the control group(P < 0.05).6. The indicators of social benefit: Hospitalization days of patients in treated group were shorter than the control group and so was the hospitalization cost(P < 0.05).7. The occurrence of complications: Two groups of patients with the occurrence rates of gastric retention, diarrhea and vomiting in patients of treated group were signifcantly decreased when compared with the control group(P < 0.05). But the occurrence rate of upper gastrointestinal bleeding in two group showed no difference(P > 0.05).Conclusions:Compared with the traditional enteral nutrition, the combination of small dose of early enteral nutrition, supplementary parenteral and immune support shows much more benefit to the postoperative hypertensive intracerebral hemorrhage patients. And, rapid recovery by effectively improving the nutritional status and anti-infective ability, regulating the body's immunity, promoting the recovery of neural function, reducing hospitalization time and costs and the occurrence rate of complications such as gastric retention, diarrhea and vomiting were observed. |
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