Effect of different methods of applying enteral nutritional support methods in elderly patients with severe pneumonia / 中华急诊医学杂志

ABSTRACT

Objective To compare the effect of different enteral nutritional support methods in elderly patients with severe pneumonia.Methods Elderly patients (average age over 65 years) with severe pneumonia admitted to our hospital from June 2015 to June 2018 were selected as the study subjects,and 86 patients finally completed the study.The patients were randomly divided into the control group and observation group with 43 patients in each group,and nasojejunal tubes were placed for patients in both groups.Patients in the observation group were fed with enteral nutrition emulsion through continuously-heated nutritional pump,while patients in the control group was meal served with enteral nutrition emulsion.Changes in blood biochemical parameters,immune indexes,inflammation indexes,oxygenation indexes,the GIDF and SOFA scores as well as curative effect (mechanical ventilation time and effective rate of treatment) were monitored and compared before and after 10 days of nutritional support treatment.SPSS 20.0 statistical software package was used for data analysis,and self paired t-test was used for comparison before and after intervention in the same group,x2 test was used in comparison between different groups,and the counting data was expressed as the rate (n,％).Results There was no significant difference in baseline data between patients in the two groups (P＞0.05).After ten days of intervention,compared with the control group,the levels of serum albumin and prealbumin in the observation group were higher [(31.22±2.36) g/L and (0.29±0.24) g/L,P=0.015 and P=0.023],the immune indexes were higher [IgG (13.24±0.70) g/L,P=0.020;IgM (1.43±0.19) g/L,P=0.011;CD4+/CD8+ 1.55±0.49,P=0.043],the inflammation indexes were lower [IL-6 (312.54±42.53) pg/mL,P=0.031;PCT (1.56±0.81) ng/mL,P=0.017],the oxygenation indexes were better [PaO2/FiO2 (315.58±20.37) mmHg,P=0.019],and the GIDF and SOFA scores were significantly lower[(10.6±l.2) and (8.5±1.7),P=0.041 and P=0.038].The clinical outcome showed that the mechanical ventilation time in the observation group was significantly shorter [(6.01±1.48) d vs (8.12 ± 1.17)d,P=0.039],and the total effective rate of treatment was better than the control group (67.44％ vs 41.86％,P=0.027).Conclusions Enteral nutrition support through continuously-heated nutritional pump can improve the nutritional status of elderly patients with severe pneumonia,reduce the incidence of gastrointestinal dysfunction,maintain stable organ fuction,thus resulting in better prognosis in elderly patients with severe pneumonia.