Clinical observation of sequential enteral and parenteral nutrition support adjuvant therapy on acute cerebral stroke with dysphagia
Objective To explore the effect of sequential enteral and parenteral nutrition support adjuvant therapy on nutri-tional status,neurological function and complications in patients with acute cerebral stroke complicated with dysphagia.Methods A total of 102 patients with acute cerebral stroke and dysphagia who were treated in Zhecheng People's Hospi-tal from January 1,2017 to January 31,2019 were selected as study subjects.According to the principle of comparability of gender,age,disease type,and time from illness to admission,the patients were divided into observation group and control group with 51 cases in each group.The control group was given full enteral nutrition and conventional parenteral nutrition support with fat emulsion amino acid glucose injection,while the observation group was given sequential enteral and parenteral nutrition support,including nasal feeding tube infusion of short peptide and full capacity enteral nutrition support,combined with parenteral nutrition support such as fat soluble vitamins,fat emulsion injection,and compound a-mino acid injection.We compared the nutritional status and neurological function changes of two groups of patients before and 14 days after intervention,and recorded the occurrence of related complications during the observation period usingx2 or t-test.Results Before intervention,there was no statistically significant difference in the levels of serum prealbumin(PA),serum albumin(ALB),hemoglobin(Hb),and serum total protein(TP)between the two groups of patients(P＞0.05).After intervention,the levels of PA,ALB,Hb,and TP in both groups of patients decreased compared to before intervention.However,the PA levels in the observation group was(258.42±14.15)mg/L,higher than that in the con-trol group(204.23±15.74)mg/L,t=18.284,P＜0.001.The ALB level was(33.42±3.27)g/L,which was higher than the control group's(30.11±3.43)g/L,t=4.988,P＜0.001.The Hb level was(132.56±7.27)g/L,which was higher than the control group's(128.26±7.08)g/L,t=3.026,P=0.003.The TP level was(70.29±2.34)g/L,which was higher than the control group's(61.81±3.05)g/L,t=15.753,P＜0.001.Before intervention,there was no statistically significant difference in the national institutes of health stroke scale(NIHSS)scores between the two groups of patients(P＞0.05).After intervention,the NIHSS scores of both groups of patients decreased compared to before in-tervention,but the NIHSS scores of the observation group was(15.91±2.63)points,lower than the control group's(17.61±3.42)points,with a statistically significant difference(t=2.814,P=0.006).The total incidence of complica-tions in the observation group was 17.65％,higher than 52.94％in the control group,with a statistically significant difference,x2=13.909,P＜0.001.Conclusion Sequential enteral and parenteral nutrition support can effectively im-prove clinical symptoms and nutritional status in patients with acute stroke accompanied by swallowing disorders,reduce the incidence of related complications,and facilitate the recovery of neurological function.
sequential enteral and parenteral nutritionstrokedysphagiaswallowing functionnutrition support
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