Effect Of Pectin On Diarrhea And Nutritional Status Of Patients With Enteral Nutrition-related Diarrhea In Severe Stroke

Purpose:To explore the effect of different doses of pectin on enteral nutrition related diarrhea and nutritional status in patients with severe stroke.Materials and methods:A prospective analysis of enteral nutrition related diarrhea patients in intensive care unit of neurology,the second affiliated hospital of Nanchang university from May 2018 to October 2019.Using the clinical randomized controlled trial research method,120 patients who met the inclusion criteria were divided into 4 groups according to the random number table method: Pectin A group(enteral nutrient solution + probiotics + pectin 45ml),pectin B group(enteral nutrient solution + probiotics + pectin 60ml),pectin C group(enteral nutrient solution + probiotics + pectin 90ml)and control group(enteral nutrient solution + probiotics).All patients were recorded at the time of admission and on the 1st,3rd,and 7th days after the intervention,and recorded the stool frequency,total stool volume,perineal skin score,GCS score,APACHE ? score,and the time point at which the patient reached the nutritional target amount.Fasting peripheral venous blood to detect hemoglobin,serum preprotein,total cholesterol and lymphocyte counts of patients to assess their nutritional status.Comparison of diarrhea and nerve function among the four groups was analyzed by Kruskal-Wallis rank sum test,univariate analysis of variance was used to analyze the nutritional status of the four groups of patients.Result:1?Comparison of diarrhea in groups:On the 1st and 3rd days of adding pectin,the stool frequency and total stool reduction level of patients in different pectin groups were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).On the 3rd day,there were statistically significant differences in the number of stools and the total stools between pectin group C and pectin group A and group B(P<0.05).On the 7th day,the number of stool,the total amount of stool and the score of perineum skin of patients in different pectin groups all decreased significantly,and there was a statistical difference between them and the control group(P<0.05).While the total stool and perineal skin scores of patients in pectin C group and pectin A group were statistically different(P<0.05).2?Comparison of nutritional status in groups:On the 3rd day after the addition of pectin,patients in different pectin groups were all higher than those in the control group,and the difference was statistically significant(P<0.05).While there were statistically significant differences in the pre-albumin value of patients in pectin group C compared with pectin group A and group B(P<0.05).On the 7th day,the prealbumin in different pectin groups showed an upward trend,while total cholesterol showed a downward trend,and the differences were statistically significant compared with the control group(P<0.05);Patients in the pectin C group had higher prealbumin than those in the pectin A and B groups,and total cholesterol was lower than those in the pectin A and B groups.The differences were statistically significant(P<0.05);There were no significant difference in prealbumin and total cholesterol between the two groups of patients with pectin A and B(P>0.05).3?Comparison of GCS and APACHE II scores in groups:(1).On the 3rd and 7th day after pectin addition,there were no significant difference in the GCS score of four groups(P<0.05).(2).On the 7th day after adding pectin,the Apache ? score of each pectin group was lower than that of the control group,the difference was statistically significant(P<0.05);The APACHE ? scores of patients in pectin C group were lower than those in pectin A and B groups,and the difference was statistically significant(P<0.05).(3).Compared with the control group,the time of achieving enteral nutrition target in different pectin groups was less,the difference was statistically significant(P<0.05).There were significant difference in the time of achieving enteral nutrition target between pectin group C and pectin group A and pectin group B(P<0.05)Conclusion:Pectin can improve the diarrhea of patients with enteric nutrition-related diarrhea in severe stroke,improve the nutritional status of patients,and promote the recovery of neurological function in patients.Among the three different dosages of pectin,90 mL pectin group had the least time to reach the target dosage of enteral nutrition,which reduced the risk of malnutrition caused by inadequate intake,and had greater advantages in improving the gastrointestinal function and nutritional status of patients.