| Objective: The purpose of this study is to explore the effect of metoclopramide combined with gastric residues threshold on nutritional status of severe patients,thereby reducing the occurrence of gastrointestinal complications,shortening the nutritional standard time of critically ill patients,improving the nutritional status of critically ill patients,and reducing the number of hospital days.Promote patient prognosis.Methods:The 120 patients who met the criteria were randomly divided into four groups,30 in Group A,enteral nutrition group(48 hours after entering the department to give enteral nutrition),30 in Group B,early enteral nutrition group(intestinal nutrition within 48 hours of entry),30 in Group C,metoclopramide group(early enteral nutrition + metoclopramide),30 in Group D,common application group(early enteral nutrition + metoclopramide+raise the threshold of gastric residual).Group A was used as a control group to analyze the test data of each group of patients.All patients collected venous blood for blood cell analysis on the first day and the seventh day of treatment to detect Protein(PR),Prealbumin(PA),Hemoglobin(HGB)values,and Totallymph ocytecount(TLC),immunoglobulin A(IgA),G(IgG),M(IgM),T cell subgroups(CD3,CD4,CD8);The gastrointestinal functional conditions(abdominal distension,diarrhea,vomiting,reflux,constipation)and Body mass index(BMI)were observed.To observe the time of use of ventilator,the days of ICU hospitalization,the total days of hospitalization and the time of nutritional standards.Results:1.Nutritional indicators: the BMI index of the four groups of patients was not statistically significant before and after treatment and between groups(P>0.05).There was little change before and after the treatment of group A total protein,and the difference was not statistically significant(P>0.05),after the treatment of group B,C,and D total protein,the difference was statistically significant compared with that before treatment(P<0.05),the difference in total proteins in groups B,C,and D after treatment was statistically significant compared to group A(P<0.05),there was no statistical difference between the total proteins in groups B,C,and D after treatment(P>0.05).Before and after the treatment of prealbumin in groups A and B,the difference was not statistically significant(P>0.05),the difference between prealbumin in groups C and D after treatment was statistically significant compared with that before treatment(P<0.05),the difference between group D and group A,B,and C after treatment was statistically significant(P<0.05).The hemoglobin treatment of the four groups was higher than before the treatment,and the difference was statistically significant(P<0.05),the difference in hemoglobin in groups B,C,and D after treatment was statistically significant compared to group A(P<0.05),the difference was statistically significant between group D and group B hemoglobin after treatment(P<0.05).2.Immunization indicators: there was no statistically significant difference between the pre-treatment CD3 and CD4 after treatment in groups A,C,and D(P>0.05),and the difference was statistically significant after treatment in group B compared to pre-treatment CD3 and CD4(P<0.05),there was no statistically significant difference between the CD3 and CD4 groups after the treatment of four groups A,B,C,and D(P>0.05).There was no statistically significant difference between the pre-treatment CD4 and CD8 after treatment in groups A,C,and D(P>0.05),and the difference was statistically significant after treatment in group B compared to pre-treatment CD4 and CD8(P < 0.05),the difference was statistically significant after treatment of CD4 and CD8 in group B compared with those in groups A,C,and D(P < 0.05).After the treatment of four groups A,B,C,and D,the difference was not statistically significant(P>0.05),compared to the pretreatment CD4/CD8,and after the treatment,the four groups A,B,C,and D were compared to CD4/CD8,the difference is not statistically significant(P>0.05).There was no statistically significant difference between group A TLC,IgA,IgG,and IgM before and after treatment(P>0.05),and the difference was statistically significant after treatment in group B compared with pre-treatment IgA and IgM(P<0.05),after treatment,group B TLC and IgM were higher than group A,and the difference was statistically significant(P<0.05),the difference between Group C IgG and IgM after treatment and before treatment was statistically significant(P<0.05),the difference was statistically significant after treatment compared with Group C IgG and IgM(P<0.05),the difference between IgG and IgM in group D after treatment was statistically significant compared with that before treatment(P<0.05),the difference between IgG and IgM in Group D and A and B after treatment was statistically significant(P<0.05).3.Clinical indicators: after treatment,B,C,D groups had a significant reduction in mechanical ventilation time,ICU hospitalization days and total hospitalization days,and nutritional standards compared to Group A,and the difference was statistically significant(P<0.05);At the same time,in terms of mechanical ventilation time,ICU hospitalization days and total hospitalization days,and nutritional standards,the performance was group D<Group C<Group B<Group A,the difference is statistically significant(P<0.05).4.Gastrointestinal complications: four groups of patients with abdominal distension,diarrhea,vomiting,reflux,constipation before and after treatment,no statistical significance(P>0.05).Conclusion:Use metoclopramide and increasing the threshold of gastric residue can promote the effective implementation of enteral nutrition in severe patients,protect the gastrointestinal function of patients,and can then shorten the nutritional standards of severe patients,improve the nutritional status of severe patients,and improve immunity.Reduce mechanical ventilation time,ICU hospitalization days and the total number of hospital days,thus improving the prognosis of critically ill patients.And it does not increase treatment-related complications. |
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