Effect Of Early Enteral Nutrition With Bifidobacterium On Nutritional Status In Patients With Severe Cerebral Hemorrhage

Objective: To investigate the effects of early enteral nutrition supplement with bifidobacterium on nutritional status,gastrointestinal function and prognosis in patients with severe cerebral hemorrhage.Methods:1.A randomized controlled clinical trial was conducted in this study.A total of 81 patients with severe cerebral hemorrhage who met the inclusion criteria were randomly divided into two groups by coin flipping: bifidobacterium group(early enteral nutrition+probiotics)and conventional group(early enteral nutrition).All cases were given the evacuation of intracranial hematoma after admission to the intensive care unit,and application of Early Enteral Nutritional through the nasogastric tube within 24 to 48 hours after operation were administered on all patients.Besides conventional methods,probiotic preparation–bifidobacterium(Tablets,2g,tid(09:00?17:00?23:00).)was added to the bifidobacterium group.2.The assessments were conducted on the 1st,7th,14 th,and 21 st days after the admission to intensive care unit,including laboratory indicators: prealbumin(PA),lymphocyte count(LC),serum total protein(TP),serum albumin(ALB);Physical measurements: patient upper arm circumference(AC),triceps skinfold thickness(TSF)and calculation of upper arm muscle circumference(AMC(cm)= AC(cm)-3.14 × TSF(cm));observation of the the patient's gastrointestinal function status within 21 days: reflux,stomach retention,vomiting,bloating,diarrhea,constipation,time before reaching target energy supply;Record: GCS score,APACHE II score on days 1,7,14,21.Results:1.The nutritional status of the two groups of patients:(1)There was no significant difference on the first day in PA,LC,TP and ALB between the two groups(P>0.05).On the 7th day,PA,ALB and TP decreased to different extents.There was no significant difference between the two groups(P>0.05).On the 14 th day,the PA,ALB and TP in the two groups had a rising trend.The PA,TP and ALB of the bifidobacterium group were higher than the conventional group,however,there was no significant difference between the two groups(P>0.05).On the 21 st day,the PA,TP and ALB of the bifidobacterium group were higher than the conventional group,and the PA level in the bifidobacterium group was statistically higher than that in the conventional group(P<0.05).The LC of the two groups showed an upward trend during the study period,however,there was no significant difference(P>0.05).(2)The AC,TSF and AMC of the two groups continued to decrease on the 7th,14 th day,however,there was no significant difference between the two groups(P>0.05).Despite the loss of AC,TSF and AMC compared with its original states,they had a significantly increasing trend during the study(P<0.05).2.Gastrointestinal function: 1)The occurrences of gastrointestinal adverse reactions including gastric retention,diarrhea and constipation in the bifidobacterium group were significantly lower than that in the conventional group(P<0.05).2)The time of gastrointestinal dynamic recovery was significantly shorten(P<0.05).3.GCS?APACHE II score: On the first day of admission to the intensive care unit,the GCS and APACHE II scores of the two groups were not statistically significant(P>0.05).On the 7th day,the 14 th day and the 21 st day,the GCS scores of the two groups were significantly higher than those of the two groups.On the 21 st day,the bifidobacterium group increased significantly(P<0.05).On the 7th day,the 14 th day and the 21 st day,the APACHE II scores of the two groups were significantly lower than those of the two groups.On the 21 st day,the bifidobacterium group decreased significantly(P<0.05).Conclusion:1.Early enteral nutrition with bifidobacterium can effectively improve the nutritional status of patients with severe cerebral hemorrhage with nutritional risk.2.Early enteral nutrition with bifidobacterium can improve gastrointestinal function,feeding tolerance,the absorption of nutrients in patients with severe cerebral hemorrhage.3.Early enteral nutrition with bifidobacterium may improve the nutritional status of patients with severe cerebral hemorrhage,which may indirectly benefit the recovery of neurological function,and reduce the severity of the disease.