The Effect Of Enteral Plus Parenteral Nutrition On Early Nutrition And Immune Function In Nerve Critically Ill Patients

Purpose: By observing the nutritional status of critically ill patients in jili universityneurology intensive care unit (N-ICU)，they were given enteral nutrition and addedparenteral nutrition depending on the circumstances. Analyzing the influence of the variousof nutrient supply on the early nutrition and immune function in order to master a greaterSolutions, better nutritional support.Methods: Choosing the patients in neurology intensive care unit from June2013toFebruary2014in the First Hospital of Jilin University. The patients need nasogastric tubeenteral nutrition, the total energy require to achieve25kcal/(Kg.d), not less than one week.They are given the enteral nutrition or the parenteral nutrition in the early and adjusting thenutrient intake depending on circumstances. Comparison of the basic difference between thegroups about basic situation, the serum protein，immune parameters observed duringdifferent treatment methods. Using the SPSS17.0software for statistical analysis,_measurement data use the t test with the mean±standard deviation (x±s),, datecomparison between the three groups using analysis of variance, p<0.05there arestatistically significant.Results: The EN group, EN+early PN group and EN+supplemented PN group ofpatients admitted to hospital whose gender, age, serum protein、immune parameters arenot obvious difference; Comparison of the group and intra-group after treatment, statisticalanalysis of the data suggest that the serum protein levels of the EN group is decreased. Forthe EN+early PN group and EN+supplemented PN group, the pre-albumin、retinol bindingprotein levels are increased that have accepted treatment for one week, the difference isstatistically significant(p<0.05). The total protein、albumin、pre-albumin、transferrin of theEN+early PN group and EN+supplemented PN group are higher than the EN groupa aftertreatment, the difference is statistically significant(p<0.05). EN+supplemented PN groupthat accepted treated, the C3、C4、IgM、IgA is higher than before, for the EN+early PNgroup, the IgG、 IgA leves is higher than before, the difference is statistically significant(P<0.05). The EN+early PN group, the IGA、IGG levels is higer than the ENgroup after nutrition support. Among the three groups about the TLC after treatment,EN+early PN group and EN+supplemented PN group is higer than EN group, the differenceis statistically significant(p<0.05).Conclusion: For the neurological ill patients, achieving energy targets earlier mayprevent malnutrition and immune dysfunction occurs;Simply enternal nutrition therapy in theshort term(one week),decreased serum protein easily lead to malnutrition; For the acutephase(one week),the enteral plus parenteral nutrition is better than the simply enteralnutrition to improve the nutritional and immunological indicators for the neurologicalcritically ill patients; The early add parenteral nutrition is better than the supplementparenteral nutrition to improve malnurtrition and immune function.