The Effect Of Rhubarb On The Prevention Of Pneumonia In Patients With Acute Cerebral Infarction Fed Via Nasogastric Tubes

Objective:The pneumonia after acute cerebral infarction fed via nasogastric tubes is a common complication after stroke.There are many reasons for this,such as nasogastric regurgitation,migration of gastrointestinal tract bacteria,low immune function after stroke,and so on.It is a burden not only for the prognosis,rehabilitation and treatment and so on after stroke,but also increase the cost of hospitalization days and pressure for the family and social economy.This paper aims to study the effect of rhubarb in the prevention of acute cerebral infarction in patients fed via nasogastric tubes,and to provide better prevention and control measures for patients with acute cerebral infarction after fed via nasogastric tubes.Methods:Sixty-three stroke patients with acute cerebral infarction after fed via nasogastric tubes were enrolled.It takes randomized,single blind contrast experimental study,Those patients divided into raw rhubarb group(32 cases)and normal saline group(31 cases).After statistics analysis,the differences in age,gender,smoking,hypertension,diabetes,atrial fibrillation of two groupshave no statistical significance(P>0.05).Those are comparable.The based treatment in the two groups is same.In addition,two groups’ patients with nasogastric tubes were feed with the raw rhubarb fluid or normal saline two times every day.Then,We observe two groups’ patients peripheral blood leukocyte,CRP,nerve function defect degree(NIHSS scores)and immune function of CD3+,CD4+,CD4+/CD8+before treatment and after treatment 3 days,7 days,14 days,and the incidence of pneumonia within 14 days.The basic treatment of two groups of patients contained thrombolysis,reducing file://D:\è?-?》(?)\Youdao\Dict\7.5.2.0\resultui\dict\?keyword=lipid,neurotrophicdrugs,brain protection,dehydration and reducing cranial pressure,improving circulation,regulation of blood glucose and blood pressure,strengthen nutrition,etc.Results:Effect compare of prevention of pneumonia between two groups:In the first week,there were 2 cases of pneumonia in the rhubarb group and 7 cases in saline group.In the second week,rhubarb group and saline group occurred 2 cases and 4 casesrespectively.The total incidencesof pneumonia within 14 days of two groups are 12.5%(rhubarb group)and 35.5%(saline group)respectively.Rhubarb group was lower thansaline group significantly,the difference of incidence of pneumoniabetween the two groups was statistically significant(P<0.05).Peripheral blood leukocyte and hs-CRP:There was no statistical difference between WBC and hs-CRP in both groups before intervention(P>0.05).The WBC of rhubarb group decreased lowerthan saline group significantlyin the 3th day,7th day and 14th day after intervention.At the 14th day,the blood WBC of rhubarb group and saline grouprespectively file://D:\è?-?》(?)\Youdao\Dict\7.5.2.0\resultui\dict\?keyword=are(5.04±0.89)、(6.10±1.42),the difference of two groups was statistically significance(P<0.05).Hs-CRP in rhubarb group fall down significantly than saline group after intervention in 3th day,7th day,At the 14th days,rhubarb group blood CRP is(7.47±3.82),and saline group is(10.52±6.22),the difference was statistically significance(P<0.05).NIHSS score:There was no significant difference in NIHSS score between the two groups before intervention(P>0.05).The NIHSS score of the 3th day and 7th day after rhubarb intervention was significantly lower than that of saline group,and the difference was statistically significant(P value was 0.04 and 0.038 respectively).On the 14th day,the NIHSS score of the rhubarb group was(3.37±2.50),and the saline group was(4.50±2.62).The rhubarb group was slightly lower than the saline group,but the difference was not statistically significant(P>0.05).Immunological function:There was no statistically significant difference between CD3+,CD4+,CD4+/CD8+in the two groups before intervention(P>0.05).From the 7th day to the 14th day after the intervention of rhubarb,the increase of CD3+was significantly higher than that of saline group,and the difference was statistically significant(P<0.05).The CD4+,CD4+/CD8+of rhubarb groupin 3th days,7th days and 14th days are rising higher than saline group,and the differences are statistically significant(P<0.05),This suggests rhubarb have promote recover of immune function of patients with acute cerebral infarction after fed via nasogastric tubes.Adverse reactions:In these aspects of two groups:nausea,vomiting,diarrhea,abdominal pain,reflux of gastric juice,there were no statistical significance(P>0.05).In terms of abdominal distension,constipation,saline group obviously more than rhubarb group,and the difference is statistically significant(P<0.01).Conclusion:Rhubarb can reduce the incidence of pneumonia in patients with acute cerebral infarction fed via nasogastric tubes.Rhubarb can reduce the level of white blood cells and CRP in peripheral blood of patients with acute cerebral infarction fed via nasogastric tubes,also it alleviate the inflammatory response of patients and reduce the translocation of gastrointestinal bacteria and endotoxin.There was a certain improvement in the early nerve function in patients with acute cerebral infarction,but there was no significant improvement in neural function in final acute phase.Rhubarb can promote the recovery of gastrointestinal function in patients with acute cerebral infarction,and enhance the function of immune function.Rhubarb has good safety and efficacy in patients with acute cerebral infarction fed via nasogastric tubes,and is worthy of clinical promotion.