Individualized Enteral Nutritional Support Impact On The Nutritional Status Of Stroke Patients With Dysphagia

ObjectiveThis study investigated the effects of individualized enteral nutrition(EN)support on nutritional status,gastrointestinal complications,neurological function,and activities of daily living in stroke patients with nutritional risk and dysphagia.Method160 cases of stroke patients with nutritional risk and dysphagia were randomly divided into two groups,80 patients in the research group were treated with individualized EN support with different formula and concentration according to the actual situation of the patients,while the other 80 patients in the control group were treated with sequential EN support in which transformed gradually from short-peptide to total-protein EN.The changes of NRS2002 scores,nutritional related indicators and immune index,incidence of complications,the time to reach the target dose of EN,hospitalization days and hospitalization expenses,nerve function evaluation index(NIHSS score)and Barthel ADL index(Barthel Index,BI score)were compared between the two groups at the first day of admission and at discharge.The data were statistically analyzed by t test and chi square test.Result1.After nutritional intervention,NRS2002 scores of the study group and the control group at discharge were(2.46± 0.64)and(2.73 ± 0.90),the difference was statistically significant(t=-2.132,P=0.035);there were 6 patients with nutritional damage in the study group and 22 patients with nutritional damage in the control group,and the difference was statistically significant(x2= 12.156,P=0.002).2.After nutritional treatment,except the triceps skinfold thickness(TSF)and arm muscle circumference(MAMC),the albumin(ALB),prealbumin(PA),retinol binding protein(RBP),hemoglobin(HGB)and total lymphocyte count(TLC)at discharge were significantly increased than those at the first day of admission in the group,compared with the control group,the differences were statistically significant(P<0.05).3.After nutritional treatment,compared with the incidence of pulmonary infection,gastric retention,aspiration,abdominal distension and diarrhea between the study group and the control group,the differences were statistically significant(x2=4.212,P=0.04:x2=4.269,P=0.039;x2=6.582,P=0.01;x2=4.708,P=0.03;x2=6.582,P=0.01).4.After nutritional intervention,the time to reach the target dose of EN,hospitalization days in the study group were significantly shorter than those in the control group(t=-2.50,P=0.013;t=-2.498,P=0.014);hospitalization expenses in the group were significantly lower than those in the control group(t=-2.994,P=0.003);the nerve function evaluation index(NIHSS score)and Barthel ADL index(Barthel Index,BI score)were significantly different in the study group compared with the control group(P<0.05).ConclusionPersonalized EN support can reduce the nutritional risk of stroke patients with nutritional risk and dysphagia,improve the nutritional status and immune function,reduce the incidence of complications,shorten the time to reach the target dose of EN and hospitalization days,reduce hospitalization expenses,enhance the neurological function and activities of daily living,it is worthy of clinical promotion.