Effects Of Fat-Improved Enteral Nutrition On Nutrition And The Metabolism Of Lipid In Severe Patients

ObjectiveTo investigate the effect of fat-improved enteral nutrition on the nutrition and fat metabolism,and explore the optimal enteral nutrition formula for ICU patients with severe diseases.Methods1.This study took 70 patients admitted to the General Intensive Care Unit of the first affiliated hospital of Zhengzhou university from August 2017 to November 2018 as the research object.Patients were divided into experimental group and control group by random number table method.The experimental group was fed with fat-improved enteral nutrition,and the control group was fed with standard enteral nutrition.2.Enteral feeding of 500 ml or more for the first time was defined as day one of the study.Respectively in patients with enteral nutrition(D0)on the same day,D3,D5,evaluating and recording the general data of two groups of patients,nutrition evaluation index,fat metabolism,inflammation,APACHE-? score.At the time of discharge,ICU admission time,hospitalization time and mechanical ventilation time were calculated.During enteral nutrition feeding,the duration and frequency of intolerance of enteral nutrition feeding,including diarrhea,vomiting,gastric retention,abdominal distension,and constipation,were recorded daily.3.Spss21.0 statistical software was used for data processing and Graph Pad Prism5.3 mapping software was used for mapping.Descriptive statistical analysis,t-test of two independent samples,t'-test,repeated measurement anova,nonparametric test and other statistical analysis methods were used for data processing.Result1.In this study,33 cases were included in the experimental group and 34 cases in the control group,a total of 67 cases were included.One patient in the experimental group was transferred to the general ward on the 5th day of the study,while one patient couldn't get in touch due to the change of phone number.One case in the control group died on the third day of the study.There was no significant difference in general data between the two groups(P>0.05).2.Repeated measurement anova results showed that the total scores of serum albumin,prealbumin and hemoglobin in the test group and the control group did not change with time in enteral nutrition feeding D0,D3 and D5 days(P>0.05).3.The average value of ALB in the test group increased gradually from 30.94g/L to 32.01g/L and 33.71g/L,the average value of PA increased gradually from 133.18mg/L to 137.12 mg/L and 138.79 mg/L,and the average value of HB increased gradually from 94.02 g/L to 94.96 g/L and 97.62 g/L.4.The average ALB in the control group gradually increased from 30.65 g/L to30.91 g/L and 32.00 g/L,the average PA gradually increased from 136.29 mg/L to136.85 mg/L and 137.15 mg/L,and the average HB gradually changed from 93.56g/L to 93.51 g/L and 95.38 g/L.5.The results of repeated measurement anova showed that the total cholesterol,triglycerides,LDL and HDL scores of the experimental group and the control group did not change with time in the intestinal nutrition feeding D0,D3 and D5 days(P>0.05).6.The mean values of triglycerides in the experimental group gradually changed from 1.48 mmol/L to 1.46 mmol/L and 1.31 mmol/L,the mean values of total cholesterol gradually changed from 2.96 mmol/L to 3.15 mmol/L and 3.05 mmol/L,the mean values of low-density lipoprotein gradually changed from 1.58 mmol/L to1.84 mmol/L and 1.97 mmol/L,and the mean values of high-density lipoproteingradually changed from 1.25 mmol/L to 1.29 mmol/L and 1.27 mmol/L.7.The mean values of triglycerides in the control group gradually changed from1.44 mmol/L to 1.40 mmol/L and 1.34 mmol/L,the mean values of total cholesterol gradually changed from 3.48 mmol/L to 3.34 mmol/L and 3.53 mmol/L,the mean values of low-density lipoprotein gradually changed from 1.59 mmol/L to 1.73mmol/L and 1.96 mmol/L,and the mean values of high-density lipoprotein gradually changed from 1.17 mmol/L to 1.25 mmol/L and 1.24 mmol/L.8.The total number of cases of feeding intolerance was 39(58.21%).In the experimental group,14 cases(42.42%)were intolerant of enteral nutrition,including6 cases(42.86%)of abdominal distension,5 cases(35.71%)of diarrhea,2 cases(14.29%)of gastric retention,and 1 case(7.14%)of vomiting.In the control group,25 cases(73.53%)had no tolerance to enteral nutrition,including 13 cases(52.00%)of diarrhea,7 cases(28.00%)of abdominal distension,3 cases(12.00%)of gastric retention,and 2 cases(8.00%)of vomiting.9.During enteral nutrition,the mean time of first diarrhea in the experimental group was 10.6 1.95,and the mean time of first diarrhea in the control group was 4.081.26,with statistically significant difference(t=-8.488,P=0.000).10.There was a statistically significant difference in the number of days in which patients were free of mechanical ventilation within 28 days between the two groups(Z=-3.128,P=0.002),and no statistically significant difference in ICU stay time or total hospital stay between the two groups(P>0.05).ConclusionThe new fat modified enteral nutrition is an effective enteral nutrition preparation.It can effectively improve the nutritional status of ICU patients with severe diseases,reduce the incidence of feeding intolerance,reduce the incidence of diarrhea,delay the start time of the first diarrhea,reduce the mechanical ventilation time of severe patients,and improve the prognosis of severe patients.