ABSTRACT
Objective:To investigate the effect of early enteral nutrition on ventilator-associated pneumonia in patients with severe cerebrovascular disease,and to evaluate nutritional status,intestinal nutrition tolerance,pH value of gastric juice and incidence of gastrointestinal bleeding.Methods:This study was a prospective study.The subjects were 72 patients with severe cerebrovascular disease in the intensive care unit of Neurology Department of our hospital from March 2014 to May 2017.All patients were treated with nasal feeding and mechanical ventilation.Among them,36 patients received enteral nutrition support treatment within 24 hours (early group),and 36 patients received enteral nutrition support treatment after 24 hours (control group).The two groups were compared with the incidence of ventilator-associated pneumonia,weaning success rate,complications of enteral nutrition rate,and gastrointestinal bleeding within 7 days,serum albumin and serum prealbumin level after 7 days,survival rate after 28 days.We also analyzed the changes in pH of the gastric juice at admission,1 day,3 days,7 days,and 14 days after treatments.Results:In the early group,the incidence of ventilator-associated pneumonia,gastrointestinal bleeding,complications of enteral nutrition,were lower than the control group.The serum level of albumin and prealbumin,the rate of successful weaning and 28 day survival rate were higher than the control group.After the early enteral nutrition,the pH value of gastric juice increased significantly.Conclusion:Early application of enteral nutrition support therapy can improve the nutritional status of patients,reduce the incidence of ventilatorassociated pneumonia,improve the success rate of weaning,reduce the fatality rate and improve the prognosis of patients.Early enteral nutrition support treatment can also increase pH value of gastric juice and reduce the incidence of gastrointestinal complication and gastrointestinal bleeding.
ABSTRACT
Objective To discuss the intensive gastric cavitary lavage method in treatment of stress ulcer bleeding(SUB).Methods The therapeutic effects of 100 patients with severe SUB in intensive care unit (ICU)from July 2005 to February 2008 treated with intensive gastric cavity lavage method were observed and analyzed.Results In these 100 cases,the bleeding was stopped successfully in 97 cases,the therapeutic effective rate being 97%;there were 17 cases died of complicated pulmonary infection(17%)and 3 cases of bleeding(3%),the total fatality rate being 20%.All the other cases were cured.Conclusion Intensive gastrointestinal lavage therapy is an effective method as acid inhibitor for treatment of SUB,but it can decrease the inhabitant flora in the stomach to pass through gastric-pulmonary route,thus the incidence of pulmonary infection was reduced.
ABSTRACT
Objective: To investigate the treatment effect of rational enteral nutrition in stress ulcer bleeding after severe brain injuries.Methods: 30 cases with severe brain injuries accompanied with stress ulcer bleeding were supported by enteral nutrition as clinical treatment group.50 cases with the same conditions were managed with traditional treatment methods as control.Results: All patients in clinical treatment group had no stress ulcer bleeding any more. The nutritional state was improved. On the other hand,the stress ulcer bleeding occurred again and again and the nutritional state was poor.Conclusion: Rational enteral nutrition can treat upper gastrointestinal stress ulcer bleeding in severe brain injuries effectively.