Clinical Study Of Jejunal Tube Nutrition In Patients With Stroke-related Pneumonia

ObjectiveBy analyzing the methods of enteral nutrition,summarizing the nursing points of enteral nutrition,and comparing the different ways of nutritional nasogastric feeding,the clinical effect of enteral nutrition after stroke complicated with apoplexy related pneumonia was emphatically discussed,so as to provide a reference for the implementation of enteral nutrition in such patients.MethodA total of 96 patients diagnosed with stroke with dysphagia requiring enteral nutrition treatment and associated pneumonia during hospitalization who visited the First Affiliated Hospital of Zhengzhou University from August 2017 to June 2019 were collected.According to the random number method,the research subjects were classified into the following 2 groups: the experimental group(ie the nasojejunal tube group)and the control group(ie the nasogastric tube group),with the same number,the control group routine nasogastric tube enteral nutrition therapy and other treatment no obvious difference was found between two groups,including stroke treatment,hypostatic pneumonia prevention,application of antibiotic and routine nursing care,etc.The nutritional indexes(albumin,hemoglobin)and complications(reflux,abdominal distension,course of antibiotics,etc.)were compared between the two groups at 2 and 4 weeks,and the cure rate of pulmonary infection and length of hospital stay were observed after 4 weeks.ResultsAccording to the inclusion criteria,40 patients in the jejunum tube group and 43 patients in the nasogastric tube group finally completed the experiment.There was no significant difference in age,sex,disease composition,past history,GCS score and other general data between the two groups.At second weeks,there was no significant difference in albumin level(29.21±9.64 vs 28.76±8.96,t=0.220,p=0.826)g/L and no significant difference in hemoglobin level(109±25.71 vs 112.63±27.46,t=-0.559,p=0.578)between the jejunal tube group and the nasogastric group.The incidence of abdominal distension was 47.5%(19/40)vs 46.51%(20/43)between the jejunal tube group and the nasogastric group.In terms of the thickness of the triceps skinfold,the experimental group and the control group were 1.21±0.20,1.17±0.19,respectively.The comparison result was t=1.344 and p=0.055,that is,there was no significant difference;in terms of the incidence of reflux,the above The two groups were 12.50%(5/40)and 59%(9/43)respectively.The comparison result was ?2=1.050 and P=0.035,which means there is a significant difference.At the 4th week,on the albumin index,the experimental group and the control group were respectively 34.34±10.57 and 29.96±10.96.The comparison result was t=2.273 and p=0.026,that is,significant difference;on the hemoglobin index,the above two groups They are 118±31.71 and 116.93±29.46,respectively.The comparison result is t=0.160 and p=0.874,that is,there is no significant difference.In the 4th week of abdominal distension,the experimental group and the control group are each 15.00%(6/40),18.60%(8/43),the comparison result ?2=0.192 and p=0.661,that is,there is no significant difference;in the thickness of the triceps skinfold,the above two groups are 1.24±0.20,1.04±0.09,respectively,the comparison result T=2.642 and p=0.015,that is,there is a significant difference;in terms of the incidence of reflux,the experimental group and the control group are 7.50%(3/40)and 23.26%(10/43)respectively,and the comparison result is ?2=3.894 And t=0.048,there is a significant difference.In the course of antibiotics,the experimental group and the control group were 13.21±5.62,18.96±6.32 respectively,the comparison result was t=-4.368 and p=0.001,the former was significantly shorter.In terms of the cure rate of lung infection,the above two groups were 87.50%(35/40)and 67.44%(29/43)respectively.The comparison result was ?2=4.723 and p=0.030,the former was significantly higher.In terms of hospital stay,the experimental group and the control group were 41.25±9.68 and 45.63±1.21,respectively.The comparison result was t=-2.944 and p=0.004,which means there are significant differences.In terms of the number of deaths,the experimental group and the control group were 5.00%(2/40)and 16.28%(7/43)respectively.The comparison result was ?2=1.685 and p=0.194,showing no significant difference.ConclusionStroke patients with dysphagia are at high risk of aspiration and intestinal nutrient absorption disorders.For stroke patients with stroke associated pneumonia,enteral nutrition treatment with jejunal tube can reduce the incidence of regurgitation and muscular atrophy,shorten the course of antibiotic use and the hospital stays.So,early enteral nutrition treatment with jejunal tube is recommended.