| Background: Stroke is a multiple disease that affects the central nervous system.Because cerebral apoplexy shows high level of morbidity,recurrence rate,disability rate and fatality rate,it has become a health problem that has attracted worldwide attention.Malnutrition is one of the common complications of stroke,and nutritional support is especially important in patients with moderate to severe stroke.At present,how to scientifically and correctly manage nutrition for patients with moderate and severe stroke is still an unsatisfied demand.Therefore,this study explores effective enteral nutrition intervention methods to improve the compliance and effectiveness of nutritional therapy for patients with moderate and severe stroke,and reduce the incidence of complications caused by nutritional problems,so as to reduce the clinical adverse outcomes of patients.Objective: To observe the difference in nutritional status,complications and medical expenses of patients with moderate and severe stroke between the modified homogenate diet formula and commercial homogenate diet.To discuss the effectiveness of the modified homogenate diet in nutritional treatment of patients with moderate and severe stroke,to analyze the main factors affecting enteral nutrition treatment of patients with moderate and severe stroke,to explore the effective measures of nutritional treatment of patients with moderate and severe stroke,to improve the management of enteral nutrition for patients with moderate and severe stroke.Methods: Clinical randomized controlled trials were used,the study subjects were selected from severe stroke patients(cerebral infarction or cerebral hemorrhage)hospitalized in Baise Municipal People's Hospital.A total of 63 patients were selected according to inclusion,exclusion and shedding criteria.The selected patients were randomly divided into two groups,including 31 patients in the the modified homogenate diet group and 32 patients in the commercial homogenate diet group.Patients in both groups are those who cannot eat by themselves and adopt nasogastric enteral nutrition support.They were given two different nutrition intervention schemes within 48 hours of admission.The the modified homogenate diet group applied commercial common homogenate diet+self-made homogenate diet formula,and the commercial homogenate diet group applied commercial common homogenate diet+commercial fiber homogenate diet formula.The blood examination indexes,complications,nutrition treatment expenses,hospitalization days,medical expenses,etc.of the two groups of patients before,after 1 week of nutrition intervention and after 2 weeks of nutrition intervention were compared.Results:1.Before nutritional intervention: Comparison of gender,age,disease status,NRS score,GCS score and intravenous nutrition support between the the modified and commercial homogenized diet groups showed no significant difference among the two groups,the data showed no significant difference between the two groups(P>0.05).There were no significant differences in HB,WBC,TP,ALB,PA,RBP,BUN,Cr,UA,K,Na,Cl,between the two groups before nutritional intervention(P>0.05).The LYM index of the study group was higher than that of the control group,and the difference of LYM between the two groups was statistically significant(P<0.01).2.One week after nutrition intervention: comparison of blood test indexes between the two groups,K value in the study group was higher than that in the control group,the difference was statistically significant(P<0.01).There were no Statistical difference in Hb,WBC,LYM,TP,ALB,PA,RBP,BUN,Cr,UA,Na,Cl,Ca between the two groups(P>0.05).3.Two weeks after nutritional intervention: comparison of blood test indexes between the two groups,LYM value in the study group was higher than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in Hb,WBC,LYM,TP,ALB,PA,RBP,BUN,Cr,UA,Na,Cl,Ca between the two groups.(P>0.05).4.Before and after nutrition intervention: The index changes of Hb,WBC,LYM,TP,ALB,PA,RBP,BUN,Cr,UA,K,Na,Cl,Ca in patients of the study group before nutrition intervention,one week after nutrition intervention and two weeks after nutrition intervention were analyzed by variance analysis.Among them,the Na index after one week of nutrition intervention was lower than that before nutrition intervention,and the difference was significant(P <0.05).The comparison of other indexes before and after nutrition intervention showed that the P value was above 0.05,which showed no statistical difference.In the control group,WBC index before nutrition intervention was lower than that after 2 weeks,and the difference was statistically significant(P<0.05),while there was no statistically significant difference between before and 1 week after nutrition intervention(P>0.05).5.Comparison of clinical outcomes between the two groups: there was no statistical difference in the incidence of complications between the two groups(P>0.05).6.Comparison of 2 weeks' nutritional cost,total hospitalization days and medical cost between the two groups: The nutritional cost of the modified homogenized diet group for 2 weeks was significantly lower than that of the commercial homogenized diet group for 2 weeks,with statistically significant difference(P<0.01).Comparison of hospitalization days and hospitalization medical expenses between the two groups showed that P values were all greater than 0.05,indicating no statistical difference.Conclusion:1.Comparative analysis of the two groups of subjects without nutrition intervention and nutrition-related index changes after nutrition intervention,the incidence of complications have no difference,indicating that the self-made homogenate diet formula and commercial homogenate diet preparation used in the the modified homogenate diet group in this topic have the same nutritional value,and the modified homogenate diet formula is an effective enteral nutrition preparation,suitable for patients with moderate to severe stroke.2.There is a significant difference in the 2-week nutritional support costs between the two groups of patients.Patients using commercial homogenate meal need much higher nutritional support costs than patients using homemade homogenate meal.Therefore,the the modified homogenate diet formula in this study is an effective and inexpensive enteral nutrition scheme.It has high cost performance,can reduce the economic burden of stroke patients,and is suitable for promotion in patients who need enteral nutrition support for a long time. |
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