Intestinal nutrition support strategy for neurosurgical critically ill patients with dysphagia
Objective To explore the nursing based on the enteral nutrition support strategy for neurosurgical critically ill patients with dysphagia.Methods One hundred and eighty neurosurgical critically ill patients with dysphagia admitted to Wuxi Second People's Hospital from January 2021 to January 2023 were selected for the randomized controlled trial,and were divided into a control group and an observation group by the random number table method,with 90 cases in each group.There were 50 males and 40 females in the control group;they were(56.11±3.58)years old.There were 48 males and 42 females in the observation group;they were(56.26±3.85)years old.The control group took traditional nursing intervention,and the observation group took the enteral nutrition support strategy on the basis of control group.The clinical indicators,incidences of complications,and nutritional indicators,scores of Glasgow Coma Scale(GCS)and Dysphagia Severity Rating Scale(VGF),and immune indicators before and 2 weeks after the intervention and were compared between the two groups.t and x2 tests were applied.Results The NSICU stay and ventilator support time in the observation group were shorter than those in the control group[(12.01±2.68)d vs.(13.59±3.02)d and(5.03±1.02)d vs.(6.68±1.30)d],with statistical differences(t=3.712 and 9.473;both P＜0.001).Two weeks after the intervention,there were statistical differences in the levels of albumin(ALB),prealbumin(PAB),and total protein(TP)and the scores of GCS and VGF between the observation group and the control group[(40.54±2.12)g/L vs.(33.57± 2.03)g/L,(39.25±3.41)g/L vs.(30.26±2.68)g/L,(70.64±5.74)g/L vs.(62.31±5.1 1)g/L,(13.54± 1.67)vs.(9.11±1.05),and(8.56±1.21)vs.(7.21±1.03);t=22.528,19.664,10.283,21.304,and 8.060;all P＜0.001].There were statistical differences in the levels of immunoglobulin(IgA),IgG,and IgM between the observation group and the control group[(2.45±0.65)g/L vs.(2.12±0.49)g/L,(13.89± 2.14)g/L vs.(12.44±2.02)g/L,and(1.92±0.63)g/L vs.(1.57±0.52)g/L;t=3.846,4.674,and 4.065;all P＜0.001].The incidence of complications in the observation group was lower than that in the control group[5.56％(5/90)vs.14.44％(13/90)],with a statistical difference(x2=3.951;P=0.047).Conclusion Nursing based on the enteral nutrition support strategy for neurosurgical critically ill patients with dysphagia can effectively shorten their NSICU stay and ventilator support time,improve their nutritional indicators,swallowing function,and immune function,and reduce the incidence of complications.
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