Effectiveness of enteral nutrition support for stroke patients with gastric retention / 中国中西医结合急救杂志

ABSTRACT

ObjectiveTo observe the clinical curative effect of nasal jejunal nutrition support in stroke patients with gastric retention.Methods Forty-two patients with cerebral apoplexy combined with gastric retention admitted to Dingxing County Hospital in Hebei province from March 2012 to November 2015 and treated with enteral nutrition support were enrolled, and they were divided into observation group and control group according to the random number table method, 21 cases in each group. Under the guidance, routine treatment were given, the head of bed was raised to 30°- 45°, and gastrointestinal decompression was carried out in the two groups. In the observation group, a nasal jejunal tube was inserted and enteral nutrition was given, while in the control group, parenteral nutrition was firstly applied until the recovery of gastrointestinal function, then nasogastric enteral nutrition was carried out. Compared between the two groups, on the day of admission before treatment and 2 weeks after treatment, blood glucose levels, plasma total protein levels, albumin were detected; the triceps skinfold thickness (TSF), upper arm circumference (MAC), upper arm muscle circumference (AMC), etc were measured in the two groups to show the difference in nutritional status. Adverse reactions of diarrhea, stress ulcer, gastrointestinal tract infection, reverse flow, high blood sugar and central venous infection and complications in the two groups were observed.Results The levels of blood glucose, albumin, total protein content were not significantly different between the two groups before treatment (allP > 0.05). Blood glucose levels in the two groups after treatment were lower than those on admission, and the decrease in the observation group was more significant (mmol/L 6.45±2.15 vs. 7.68±2.68,P < 0.05); the levels of albumin and total protein in the control group after treatment were lower than those on admission, while the observation group had no such significant changes, and the levels of the control group were significantly lower than those of the observation group [albumin (g/L) 30.78±4.12 vs. 38.20±4.67, total protein (g/L) 63.91±4.32 vs. 67.11±3.12, P < 0.05]. After treatment for 2 weeks, the nutritional indexes of TSF, MAC, AMC in the two groups were slightly lower than those on admission, but the degrees of descent in observation group were not as significant as those in the control group [TSF (mm) 11.91±1.29 vs. 10.13±1.37, MAC (cm) 24.19±3.12 vs. 23.74±2.08, AMC (cm) 22.64±2.05 vs. 21.73±2.15, allP < 0.05]. The incidences of adverse reactions and complications in the observation group were significantly lower than those in the control group [diarrhea 9.5% vs. 38.1%, stress ulcer 4.8% vs. 33.3%, regurgitation4.8% vs. 28.6%, hyperglycemia 9.5% vs. 38.5%,P < 0.05]; In the control group, the incidence of central venous infection was 4.8%.Conclusions Gastric jejunal nutrition support in patients with cerebral apoplexy combined with gastric retention can prevent occurrence of malnutrition, reduce the incidences of adverse reactions and complications and promote the rehabilitation of patients.