Relationship Between Standardized And Refined Enteral Nutrition And Prognosis In Patients With Severe

Objective To explore the feasibility and effect of supportive treatment plan based on standardized refinement of enteral nutrition.Methods A total of 60 patients at high nutritional risk admitted to the Neurological Intensive Care Unit(NICU)of Hohhot First Hospital between December 2019 and December 2020 were included and randomized into observation group and control group,both of which underwent a supportive process with standardized refinement of enteral nutrition based on conventional treatment.Every day,a diet plan was made,corresponding diet list was adjusted and updated,and a delicacy management was carried out according to the patients’ nutritional status and conditions.At an early stage,the observation group was given low calorie homemade homogenate diet in combination with industrial enteral nutrition powder and supplementary parenteral nutrition(SPN)intermittently,while the control group was given suspension of low calorie enteral nutrition in combination with SPN continuously.For both groups,the serum nutrition indexes(total protein,albumin,prealbumin,and hemoglobin),immunity indexes(IgA,IgM and IgG),triceps skin fold thickness(TSF),mid-arm circumference(AMC),nutric score for critical illness,and complications were observed.Results There were no significant differences in serum nutrition indexes,immunity indexes,AMC,TSF,Nutric score and the total incidence rate of complications between the two groups(P >0.05).For both groups,the total protein and albumin levels 14 d after treatment were higher than before treatment and 7d after treatment,and the levels 7 days after treatment were lower than before treatment and 14 d after treatment,and there was statistical significance for the differences(P < 0.05);the prealbumin level 14 d after treatment was higher than before treatment and 7d after treatment,and the differences were statistically significant(P < 0.05);the hemoglobin level 7d after treatment was lower than before treatment and 14 d after treatment,and the differences were statistically significant(P < 0.05);the IgA,IgM and IgG levels 14 d after treatment were higher than before treatment and 7d after treatment,and the levels 7d after treatment were lower than before treatment and 14 d after treatment,and there was statistical significance for the differences(P < 0.05);the AMC and TSF levels 14 d after treatment were higher than before treatment,and the differences were statistically significant(P < 0.05);the Nutric score 14 d after treatment was lower than before treatment,and the difference was statistically significant(P < 0.05).The incidence rate of diarrhea in the control group was higher than in the observation group,and the difference was statistically significant(P < 0.05).There were no statistically significant differences in gastric retention,constipation,upper digestive bleeding and aspiration pneumonia between the control group and the observation group(P > 0.05).Conclusions The supportive therapy with standardized refinement of enteral nutrition may improve the nutritional status and immunity of patients in the NICU effectively,thus reducing the incidence of complications,promoting their rehabilitation and bettering their prognosis.At an early stage,the low calorie homemade homogenate diet in combination with industrial enteral nutrition powder and SPN given intermittently is not significantly different from the suspension of low calorie enteral nutrition in combination with SPN given continuously in terms of nutritional status,immunity optimization and total incidence rate of complications,but the incidence rate of diarrhea for the former is lower than that for the latter.The homemade homogenate diet in combined with industrial enteral nutrition powder has the advantages of low price,convenient operation and strong compliance.It is suitable for patients who still need en treatment after discharge.