Effects Of Different Enteral Nutrition Preparations On Nutritional Status And Feeding Intolerance In Patients With Severe Cerebrovascular Disease

Objective: To explore the effects of different enteral nutrition preparations on nutritional status and feeding intolerance in patients with severe cerebrovascular disease,in order to provide a reasonable,feasible and acceptable scheme for nutritional support treatment of severe cerebrovascular disease.Methods: Prospective analysis of patients with severe cerebrovascular disease treated in the Department of Neurology in The First Affiliated Hospital of Dalian Medical University from May 2017 to December 2017.In the end,46 patients with severe cerebrovascular disease met the inclusion criteria.The patients were randomly divided into two groups: the hydrolyzed protein nitrogen enteral nutrition group and the standard formula enteral nutrition group.General data of patients(sex,age,clinical diagnosis of major diseases and basic diseases)were collected;feeding intolerance(abdominal distension,diarrhea,gastric retention)was recorded;laboratory indicators were recorded,such as albumin,total protein,hemoglobin,urea and leucocyte counts on the day of admission to the neurological intensive care unit and the first,seventh and fourteenth days of enteral nutrition application.Number,neutrophil count,lymphocyte count and so on;formulate scientific and reasonable nutrition intervention programs,such as the establishment of enteral nutrition support target quantity,enteral nutrition support methods,feeding intolerance treatment methods,etc.Data input is Microsoft Excel 2010.SPSS 17.0 software is used for statistical processing.Measurement data are expressed as mean(x(s)standard deviation.Variance analysis and t test are carried out.Comparisons of counting data are made by 2 test.There is significant difference between P < 0.05.Result:1.Comparing the general data of patients in A and B groups,the results showed that there were no significant differences in gender,age,length of stay,NUTRIC score,NISSH score and GCS score between A and B groups(P > 0.05).2.Nutrition-related laboratory indicators were compared between two groups.The results showed that there was no significant difference in ALB,TP,HB and BUN between the two groups on the day of admission and the first day of enteral nutrition(P > 0.05).Compared with the first day of enteral nutrition and the seventh day of enteral nutrition,the levels of ALB and TP in group A were significantly lower than those in group B,and the levels of ALB and TP in group A were significantly lower than those in group B.There was a significant difference between the two groups(P < 0.05).Compared with enteral nutrition on the 7th day and the 14 th day,BUN in group A and B increased significantly,but the BUN in group A was significantly higher than that ingroup B(P < 0.05).There was no difference in HB between group A and group B on the1 st day of enteral nutrition and on the 7th and 14 th day of enteral nutrition.Significant statistical significance(P > 0.05).3.Comparing the cytological laboratory indicators of patients in A and B groups,the results showed that there was no significant difference in WBC,NEUT and LYM between the two groups on the first day of admission and the first day of enteral nutrition(P > 0.05);there was no significant difference in WBC,NEUT and LYM between the two groups on the first day of enteral nutrition and the seventh day of enteral nutrition(P > 0.05);there was no significant difference in WBC,NEUT and LYM between the two groups.The changes of WBC,NEUT and LYM in group A were significantly lower than those in group B on the 7th day of enteral nutrition and the 14 th day of enteral nutrition(P < 0.05).4.Comparing feeding intolerance between group A and group B,the results showed that the incidence of feeding intolerance was 3 cases in group A,13.63% in group A,6.52% in all cases;10 cases in group B,41.67% in group B and 21.74% in all cases.There was significant difference in the incidence of feeding intolerance between groups A and B(P < 0.05).5.Comparing the symptoms of feeding intolerance between group A and group B,the results showed that there were 2 cases of diarrhea in group A,9.09% in group A,4.35% in all cases;1 case of vomiting in group A,4.55% in group A,2.17% in all cases;and 0 cases of gastric retention in group A.There were 3 cases of diarrhea in group B,12.50% in group B and 6.52% in all cases;3 cases of vomiting in group B,12.50% in group B and 6.52% in all cases;4 cases of gastric retention in group B,16.57% in group B and 16.67% in all cases.6.Comparing the time of reaching the goal of enteral nutrition between group A and group B,the results showed that the time of reaching the goal of enteral nutrition in group A was 5.22(+0.57)days,and that in group B was 5.78(+1.19)days.There was a significant difference in the time spent to reach the goal of enteral nutrition between groups A and B(P=0.031,P<0.05).7.Among the 46 patients,there were 16 cases with high NURIC score,including 7cases in Group A,3 cases in Group B and 9 cases in Group B.The incidence of feeding intolerance was 42.86%.The incidence of feeding intolerance was 100.00%.There were30 cases in Group A,15 cases in Group A,no feeding intolerance,the incidence was0.00%,15 cases in Group B,1 case in Group B,the incidence of feeding intolerance was 6.67%.Conclusion:Hydrolyzed protein as a nitrogen source of adjustable enteral nutrition can improve nutritional status of patients with severe cerebrovascular disease,and can significantly reduce the occurrence of feeding intolerance in patients with severe cerebrovascular disease.At the same time,hydrolyzed protein as a nitrogen source of adjustable enteral nutrition can reduce the time for patients to achieve the target amount of enteral nutrition,and reduce the risk of malnutrition due to inadequate intake.