| Objective:To explore the effects of target energy feeding methods on nutritional status,consciousness state and gastrointestinal complications in patients with disorders of consciousness(DOC),so as to find a suitable calculation method for energy demand of DOC patients and promote the improvement of nutritional status and gastrointestinal function of patients.Methods:From January 2022 to January 2023,seventy-four patients with DOC who were admitted to the Department of Rehabilitation Medicine in a Grade III Hospital in Nanchang City were enrolled in this study.Randomly divided into experimental group and control group.The both groups of patients were given enteral nutrition(EN)management with target energy,on the basis of routine rehabilitation treatment and rehabilitation nursing.The energy of the control group calculated at 25～30 kcal/kg·d.The Harris-Benedict(HB)formula,stress coefficient and activity coefficient were used to calculate the daily energy target of the experimental group.The nutritional biochemical indexes of total protein(TP),albumin(ALB)and hemoglobin(Hb);anthropometric indexes included triceps skinfold thickness(TSF),mid-upper arm circumference(MUAC)and arm muscle circumference(AMC);the scores of nutritional risk screening 2002(NRS 2002)and coma recovery scale-revised(CRS-R)were observed and recorded in both groups before intervention,1 week,2 weeks,and 3 weeks after intervention;the actual energy intake values,the rate of reaching the standard of energy after each week of intervention and the occurrence of gastrointestinal complications during the intervention were compared.Results:1.Comparison of basic-line information:The two groups were compared in terms of gender,age,height,disease duration,and injury type,and the differences were not statistically significant(P>0.05),and were comparable.2.Comparison of nutritional biochemical indexes:TP,ALB and Hb levels were compared between the two groups before intervention,and there was no statistical difference(P>0.05).The levels of TP,ALB and Hb were significantly higher in both groups after 1 week,2 weeks and 3 weeks of intervention compared to pre-intervention(P<0.05),and in the experimental group after 2 weeks and 3 weeks of intervention compared to control group(P<0.05).3.Comparison of anthropometric indexes:The TSF,MUAC and AMC indexes were compared between the two groups before intervention,and there was no statistical difference(P>0.05).Compared with the pre-intervention period,the indexes of MUAC and AMC in the experimental group increased after 1 week,2 weeks and 3 weeks of intervention,and the differences were statistically significant(P<0.05).The indexes of TSF,MUAC and AMC in the control group after 2 weeks and 3 weeks of intervention were higher than the pre-intervention period,and the differences were statistically significant(P<0.05).Compared with the control group,there was no statistically significant difference between the two groups after 3 time points of intervention(P>0.05).4.Comparison of NRS 2002 scores:The NRS 2002 scores were compared between the two groups before intervention,and there was no statistical difference(P>0.05).There was no significant difference in the difference between the two groups before intervention and after 1 week,2 weeks and 3 weeks of intervention(P>0.05).5.Comparison of energy intake:Compared with the control group,the average actual energy intake value of the experimental group was higher,and the difference was statistically significant(P<0.05);but the energy compliance rate was compared between the two groups after each week of intervention,there was no statistical difference(P>0.05).6.Comparison of CRS-R scores:The CRS-R scores were compared between the two groups before intervention,and there was no statistical difference(P>0.05).There was no significant difference in the difference between the two groups before intervention and after 1 week,2 weeks and 3 weeks of intervention(P>0.05).7.Gastrointestinal complications:The incidence of constipation,diarrhea,aspiration,gastric retention and vomiting was compared between the two groups,and there was no statistical difference(P>0.05).But in general,the number of gastrointestinal complications in the experimental group was more than that in the control group.Conclusions:1.Both target amount feeding methods can improve the nutritional status of DOC patients.2.The nutritional improvement of DOC patients was more significant when the HB formula was used to calculate the target amount of feeding.3.The two target feeding methods can not significantly improve the state of consciousness of DOC patients,which may be related to the lack of objective quantification and accuracy of behavioral assessment scale. |
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