| Objective: To study the application of nutritional risk screening method in Europe(NRS)2002 to evaluate the incidence of nutritional risk of maxillaofacial trauma patients,provide reliable theory for nutritional intervention measures.Analysis the effect of nutritional status and clinical outcome for the patients with maxillaofacial fractures through nasogastric feeding.Methods:1 This research selected 150 cases inpatients with maxillofacial fractures in the department of oral and maxillofacial surgery of the Third Hospital of He bei Medical University from January 2016 to January 2017.The new inpatients is complete nutritional risk screening by 2002 nutritional screening method within 24 hours(measuring weight and height,ask eating diet condition for a week before in hospital and changes in the weight for 1 to 3 months,illness,etc.).NRS nutritional risk screening 2002 includes three parts: nutritional status score(0-3),disease severity score(0-3),age grading(0-1).the NRS score is addition by three parts.Score < 3 can be divided into no nutritional risk;Score ? 3 is that has nutritional risk.The patients who had nutritional risk will be investigated.2 By teaching patients and their families the advantages of nutrition in their nasal feeding,Using a voluntary group approach,the patients with nutrition risk or malnutrition were divided into two groups.even patients received nasogastric feeding standard enteral nutrition,as experimental group;odd patients eat liquid food through the mouth as the control group.Two groups of patients were in accordance with the conventional treatment,including surgery,anti-infection and so on.The test groups were given isocaloric 125.5kJ(30kcal)/(kg.d)and isonitrogenous1.6g/(kg.d)nutrition by nasogastric.Normal homogenized meal were selected as enteral nutrition and protein powder were supplement when the protein was not enough.Nutritional support from the first day in the hospital for 7 days.The patients in control group received conventional liquid diet,and give the nutritional guidance.Results:1 In the 150 patients,the total incidence of nutritional risk is 55.9%.Mandibular fractures have the most impact in patients with maxillofacial trauma,the nutritional risk is up to 52%.Followed by multiple maxillofacial fractures,nutritional risk rate is37.5%.2 A total of 76 patients accept into the group.2 cases were automatically quit and a total of 74 patients were completely.54 cases were male,20 cases were femalets.Average age is(35.42±7.53).According to random number table,74 patients were divided into 2 groups randomly: 37 cases in control group,28 cases of male,9 cases of female.The average age is(32.9±10.8.37)cases is in experimental group,26 cases of maleand 11 cases of female,average age is(34.5±11.9).The two group patients were received the normal treatment,including surgery,antibiosis,hemostasis,etc.3 There were no statistically significant difference(P>0.05)in two groups of patients respectively,with gender,upper arm circumference,weight4 The measurement of body are left arm circumference and weight.There were no statistically significant difference(P>0.05)in two groups of patients with the left arm circumference and weight on the day before operative day.The left arm circumference were compared respectively on the preoperative and postoperative day,7 days postoperatively for control group patients.Therewere statistical significance different(P<0.05)in preoperative 7 day compared with preoperative day and postoperative day.The left arm circumference were compared respectively on the preoperative andpostoperative day,7 days postoperatively for experimental group.There were no statistical significance different(P>0.05)in postoperative day compared with preoperative day and postoperative 7 day.Compared with preoperative day and postoperative 7 day in experimental group was statistically significant difference(P<0.05).There was no statistically significant difference in weight before and after the surgery between the two groups(P>0.05).There was statistically significant difference in weight before and after the surgery in control group(P<0.05).There were statistically significant difference(P<0.05)in compared postoperative 7 day to preoperative and postoperative day respectively.Experimental group patients has no statistical significance(P>0.05)in weight.5 Laboratory measurement results.Before albumin,transferrin and lymphocyte count of two groups of patients was statistically significant difference(P<0.05)in respective groups.The serum prealbumin of experimental group were increased in the preoperative and postoperative 1 day and 7 day respectively.There was statistical significance difference(P<0.05)in compared with postoperative 7 day and preoperative and postoperative day.The serum albumin level was falling step by step on the preoperative and postoperative 1 day and 7 days respectively.Among them,compared with the postoperative 7 day and preoperative and postoperative 7 and 1 day,the results had statistical significance difference(P<0.05).In experimental group,hemoglobin content within the group is no statistical significance(P>0.05).Hemoglobin content within the control group was statistically significant(P<0.05)in the preoperative and postoperative 1 day and 7 day respectively.There was statistical significance difference(P<0.05)in control group compared with preoperative and postoperative 1 day,7 day.6 Wound infectionCompared with two groups,infection rate in experimental group was 2.7%,was 10.8% in control group.There was no statistically significant difference(P>0.05)7 Gastrointestinal complicationsIn both groups of patients,the incidence of reflux was statistically significant difference(P<0.05).Abdominal distention and constipation were compared in two groups of patients,the difference was not statistically significant(P > 0.05).8 Hospitalization time comparisonCompared two groups of patients in hospitalization time,the control group had a long time in hospital,but was similar between the two groups and has no statistical significance(P>0.05).9 The comparison of patients on medical satisfactionThe health care job satisfaction of patients' families was 80.1% in control group and 100% in the experimental group,significantly higher than the control group,the difference was statistically significant(P<0.05).Conclusion:1 In patients with maxillofacial fractures,patients with mandibular fracture has the highest incidence of nutritional risk.2 For the patients with maxillofacial fractures who have nutritional risk,enteral nutrition by nasogastric feeding can effectively improve the nutritional status.3 For nutritional risk of maxillofacial fractures were treated by many times by stomach tube push on the way of nasogastric nutrition intervention had no significant effect on infectious complications and gastrointestinal reaction.But it can improve the patients' satisfaction. |
PDF Full Text Request