| Purpose:The incidence of intestinal intolerance was compared by pumping immune nutrient solution in two different ways.The incidence of intestinal intolerance in different pumping immune enteral nutrition methods was analyzed and compared,and the related factors were analyzed,so as to explore the influence of immune enteral nutrition support on the nutritional status of patients.Method:A total of 78 patients with radical resection of esophageal cancer who met the standards of sodium and drainage in two wards of a provincial tertiary grade A tumor hospital from December 2019 to November 2020 were divided into experimental group(n=39)and control group(n=39)according to ward.The control study on intestinal tolerance of immune enteral nutrition was conducted and the clinical application effect was evaluated.Under the guidance of the concept of accelerated rehabilitation surgery and the theoretical support of the Canadian Critical Care Guidelines(2013)and the concept of accelerated rehabilitation,the experimental group was given immunological enteral nutrition support by two different pumping methods,which lasted for 6 hours and2 hours intermittently,and the control group lasted for 24 hours.According to the Guidelines for Peri-operative Nutrition Support(2016),early postoperative enteral nutrition was recommended,and the recommended energy requirements were 25-30kal/(kg-d).In all of the studies,enteral nutrition solution(TPF-T)was administered through the nasoduodenal nutrition tube.The symptoms of gastrointestinal intolerance were mainly observed in patients in the two groups,and the incidence of intestinal intolerance(nausea and vomiting,diarrhea,abdominal distension,constipation,gastric residue and abdominal pain)in patients in the two groups was compared and its related factors were analyzed.After the intervention,serum total protein,prealbumin,and albumin levels were compared between the experimental group and the control group on laboratory indicators related to nutritional status.Statistical analysis: Statistical analysis: SPSS was used 23.0 Software was used to conduct data sorting and statistical analysis.Measurement data conforming to normal distribution were represented by mean soil standard deviation,and compared by t test or repeated measurement analysis of variance.Counting data were represented by rate or composition ratio,and compared by four-grid table or RXC contingency table chi-square test.Results:1.There was no statistical significance in the general basic data between the two groups(P > 0.05).2.The incidence of intestinal intolerance symptoms: in the comparison of intestinal intolerance symptoms between the experimental group and the control group,the abdominal distension in the control group was higher than that in the experimental group,the difference was statistically significant(P < 0.05).In addition,2 patients in the control group terminated the course of immunoenteral nutrition due to severe abdominal distension,while none in the experimental group terminated the course of immunoenteral nutrition;The incidence of diarrhea in control group was higher than that in experimental group,and the difference was statistically significant(P < 0.05).The incidence of nausea and vomiting in control group was higher than that in test group,and the difference was statistically significant(P<0.05).The incidence of gastric residue in control group was higher than that in test group,and the difference was statistically significant(P < 0.05).There was no significant difference between the control group and the experimental group in constipation and abdominal pain(P> 0.05).3.Laboratory indicators:Comparison between groups: there was no statistically significant difference in serum prealbumin between the two groups on the 1st day of immunoenteral nutrition(P>0.05),but the comparison between the experimental group and the control group on the 3rd and7 th day of immunoenteral nutrition showed that the difference was statistically significant(P<0.05): There was no significant difference in serum total protein between the experimental group and the control group on the 1st and 7th days of enteral nutrition between the two groups(P > 0.05).There was no significant difference in serum albumin in the experimental group and the control group on the 1st and 7th days of enteral nutrition between the two groups(P > 0.05).Intra-group comparison: The serum prealbumin level of experimental group and control group was compared on the 1st day of enteral nutrition and the 7th day of enteral nutrition,and the difference was statistically significant(P<0.05).There was no significant difference in serum total protein between the experimental group and the control group on the 1st day and the 7th day of enteral nutrition(P > 0.05).There was statistically significant difference in serum albumin between experimental group and control group on the 1st day and 7th day of enteral nutrition(P < 0.05).Conclusion:1.The incidence of intestinal intolerance in this study was 64.1%,46.1% in the experimental group and 82% in the control group.According to the statistical results,the pumping method lasting for 6 hours and intermittent for 2 hours effectively improved the intestinal intolerance.In view of the three main clinical manifestations of enteral nutrition intolerance,nausea,vomiting,abdominal distention and diarrhea,the pump method adopted by the experimental group can effectively reduce the occurrence of these three clinical symptoms,which is more suitable for patients with enteral nutrition support after the operation of esophageal cancer.2.During the whole process of enteral nutrition immunity,the albumin level in both groups was always maintained at more than 30g/L,and the relative stability of plasma albumin was maintained,which could effectively maintain plasma osmotic pressure,and would not cause edema of small intestinal mucosa,thus increasing the absorption of nutrients.In this study,patients' serum albumin continued to rise during enteral nutrition,so effective enteral nutrition plays a crucial role in maintaining patients' albumin level.3.Serum prealbumin has a good accuracy in the assessment of enteral nutrition and intestinal intolerance in patients,so clinical medical staff should pay close attention to the level of prealbumin in patients,and at the same time,serum prealbumin is also used as an evaluation index of nutritional status.It can be concluded from this study that both groups have a positive role in improving nutritional status.However,continuous pumping for 6 hours at intervals of 2 hours in the experimental group was superior to continuous pumping for 24 hours in the control group in terms of nutritional improvement. |
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