| Objective: To screen craniocerebral injured patients by using NRS2002 nutritional risk screening chart,In order to evaluate the nutritional status of the patients,And make an investigation in regards to the nutritional support status and clinical outcome during patient's hospitalization.To comprehensive evaluate the necessity and scientific rationality of nutritional support in patients with craniocerebral injury.Methods: By using a retrospective survey method,100 craniocerebral injured patients hospitalized in Shijiazhuang No.1 Hospital during 2016.1 to 2016.12 are selected as the research objects.To screen all the patients by using NRS2002 nutritional risk screening and evaluate the effects.According to the nutritional support method of the patients,All patients were divided into enteral nutrition group(group EN),Parenteral nutrition group(PN group)and parenteral nutrition group and enteral nutrition in sequential group(PN+EN group).To statistically analyze the differences among the different groups based on the nutritional indexes,The recovery of neurological function,Infection rate,Complications,Hospitalization time,Hospitalization costs.Results: 1 The results of the nutritional status of hospitalized patients with craniocerebral injuryThe subjects in this research are all craniocerebral injured patients whose score of nutritional risk screening NRS2002 are greater than or equal to 3 points.All patients have nutritional risk and the rate of nutritional risk is 100%,so the proper nutritional support is needed.The nutrition status of which 61 patients were good,36 patients were moderate malnutrition and 3 patients were severe malnutrition.2 Changes in nutritional indicators of the three groups of patients 2.1 Changes of nutritional indexes in PN+EN group after interventionThe Hemoglobin and serum albumin in Day 7 and Day 14 were decreased than Day 1.There was no statistical significance(P>0.05).The Hemoglobin and serum albumin in Day 21 were all rose.By comparing to Day 1,Day 7 and Day 14,The difference for Hemoglobin and serum albumin has statistical significance(P<0.05).2.2 Changes of nutritional indexes in EN groupThe BMI,Hemoglobin and serum albumin in Day 7 and Day 14 were all decreased,but rose in Day 21.By comparing to Day 1,Day 7 and Day 14,There was no statistical significance(P>0.05).2.3 Changes of nutritional indexes in PN groupThe BMI,Hemoglobin and serum albumin in Day 7 and Day 14 were all decreased,but rose in Day 21.By comparing to Day 1,Day 7 and Day 14,there was no statistical significance(P>0.05).2.4 There was no statistical significance in the nutritional indexes amongst the three groups which are PN+EN group,EN group and PN group(P>0.05).Changes of nutritional indicators in Day 7,Day 14 and Day 21The Hemoglobin and serum albumin of PN+EN group and EN group in Day 7,Day 14 and Day 21 were all rose.The difference of Hemoglobin and serum albumin had statistical significance(P<0.05).The Hemoglobin and serum albumin of PN+EN group and PN group in Day 7,Day 14 and Day 21 were all rose,there was no statistical significance for BMI(P>0.05).The difference of Hemoglobin and serum albumin had statistical significance(P<0.05).There was no statistical significance between PN group and EN group in each nutritional indicator(P>0.05).3 Recovery of three groups of patients in neurological function 3.1 Recovery of discharged PN+EN group in neurological functionNIHSS score was decreased and FMA and BI scores were rose,The difference of scores had statistical significance(P<0.05).3.2 Recovery of discharged EN group in neurological functionNIHSS score was decreased and FMA and BI scores were rose,The difference of scores had statistical significance(P<0.05).3.3 Recovery of discharged PN group in neurological functionNIHSS score was decreased and FMA and BI scores were rose,The difference of scores had statistical significance(P<0.05).3.4 Comparison of recovery of three groups in neurological function between admission and discharge,Which are PN+EN group,EN group and PN groupBy comparing PN+EN group and EN and PN group,There was no statistical significance in NIHSS,FMA and BI scores when admission(P>0.05).NIHSS score is the lowest,FMA and BI scores are the highest when discharge from hospital,The difference of scores had statistical significance(P<0.001).There was no statistical significance between PN group and EN group in each nutritional indicator(P>0.05).4 The infection in three groups of patientsAfter the treatment,All three groups of patients had systemic infection occurred.It had statistical significance that the analysis and contrast of the infection cases for these three groups(P<0.05).The cases of the infection occurred in PN+EN group is the lowest.5 Complications occurred in three groups of patientsAfter the treatment,Three groups of patients had a variety of complications.It had statistical significance that the analysis and contrast of the complication rate for these three groups(P<0.05).The cases of the complications in PN+EN group is the lowest.6 Comparison amongst three groups of patients in hospitalization time and hospitalization costsThe hospital stay of PN+EN group was the shortest,And the hospital stay of PN group was the longest.It had statistical difference amongst these three groups(P<0.05).In aspect of hospitalization expenses,The cost of EN group patients was the lowest and PN group patients cost the most.It had statistical significance that the difference amongst these three groups in hospitalization expenses(P<0.05).Conclusion:1 Patients with craniocerebral injury have higher nutritional risk and there are varying degrees of malnutrition.2 The nutritional status,Recovery in neurological function,Complications,Hospitalization time and costs of craniocerebral injured patients can be improved by different nutritional support in a certain extent.Effect of the sequential treatment of parenteral nutrition and enteral nutrition is the best. |
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