The Role Of Soluble Dietary Fiber In Nutritional Support Of Patients With Severe Cerebrovascular Disease

Background and Object Severe cerebrovascular disease patients often suffer from malnutrition due to their own and disease characteristics.Early enteral nutrition support is beneficial to reduce complications and improve prognosis.Due to its own and metabolic characteristics in the intestine,SDF can play a variety of physiological roles and have beneficial effects on the intestinal function.In recent years,SDF has been gradually used in the enteral nutrition of critically ill patients.In this study,a randomized controlled study was conducted to compare and analyze the role of SDF in nutritional support of patients with severe cerebrovascular disease.Patients and methods Patients with severe cerebrovascular disease were randomly divided into SDF group and control group.After admission,nasogastric tube were indwelling within 48 h in both groups,and enteral nutrition suspension was given according to the target heat of 20~25kcal/kg/d in the acute phase.On the basis of this nutritional support,the SDF group was given SDF preparation through nasal feeding tube(10g/d),and fed in 2 times for a total of 7d.Blood test indexes(nutritional indexes,blood glucose and lipid,infection and immune indexes,intestinal mucosal barrier indexes)and gastrointestinal complications were counted before treatment and 7 days after nutritional support.SPSS21.0 was used for statistical analysis to compare the nutritional status,blood glucose and lipid,infection,immunity,and gastrointestinal complications of the two groups before and after treatment,and to analyze the role of SDF in the enteral nutritional support of patients with severe cerebrovascular disease.Results1.A total of 81 patients were monitored,including 40 in the SDF group and 41 in the control group.There was no statistically significant difference in gender,age,disease type,GCS score and APACHE II score at admission between the two groups(P>0.05).2.Nutritional indicators: from the perspective of former albumin,the SDF group increased after 7 days of treatment,and the control group decreased,with no statistically significant difference(P>0.05).From the point of view of albumin and transferrin,the two groups decreased after 7 days,and the difference between the two groups was not statistically significant(P>0.05).According to the evaluation of retinol binding protein and lymphocyte count index,both groups increased after treatment,and there was no statistically significant difference between the two groups(P>0.05).When albumin<30g/L was used as the evaluation standard for malnutrition,the incidence of malnutrition in the SDF group and the control group were 5% and 9.8% before treatment,and 12.5% and 22% after 7d,respectively,with no statistically significant difference between the two groups(P>0.05).3.Two groups of patients with diabetes were selected,13 in the SDF group and 16 in the control group.The proportion of insulin used in the SDF group(46%)was smaller than that in the control group(69%),with no statistically significant difference(P>0.05).Within 7days of treatment,insulin dosage in the SDF group gradually decreased,and on day 6 and day 7 it was significantly lower than that in the control group(P<0.05).4.Two groups were divided into two groups according to whether statins were added or not.In the lipid-lowering group,after treatment,the three blood lipid indexes were significantly lower than before(P<0.05),there was no significant difference between the groups(P>0.05).TG was used as the observation index in the non lipid lowering group,the decrease was not significant after treatment in the control group(P>0.05),and the decrease was significant after treatment in the SDF group(P<0.05).TC and LDL-C were used as the observation indexes.After treatment,they were significantly lower than before treatment.There was no significant difference between the two groups(P>0.05).5.The ratio of WBC and neutrophils decreased in the SDF group and the control group before and after treatment for 7 days,and the CRP increased.It was no statistically significant difference between the two groups(P>0.05).6.The CD3,CD4 and CD8 in SDF group and control group increased after 7 days of treatment,and increased significantly in SDF group(P<0.05),but not in control group(P>0.05).It was no significant difference between the two groups(P>0.05).7.The number of people with constipation immediately before treatment was 33 in the SDF group and 30 in the control group.After treatment for 7 days,the number of people with constipation in the SDF group was significantly less than that in the control group(P<0.05),with statistically significant differences.8.Blood DAO value of both groups decreased compared with that before treatment,the difference before and after treatment of SDF group was statistically significant(P<0.05),while the difference before and after treatment of control group was not statistically significant(P>0.05).The difference between the two groups was statistically significant(P<0.05).conclusion1.SDF can reduce the amount of insulin in severe cerebrovascular diseases patients with diabetes.2.SDF can reduce plasma TG level in severe cerebrovascular diseases patients treated without statins.3.Constipation is common in severe cerebrovascular diseases patients,and SDF can improve the constipation of patients with severe cerebrovascular disease.4.SDF can improve intestinal mucosal barrier function in severe cerebrovascular diseases patients.5.SDF has a tendency to promote the improvement of immune function in patients with severe cerebrovascular diseases.6.SDF does not show efficacy in improving nutritional status in patients with severe cerebrovascular diseases.7.SDF does not show effectiveness in infection control of patients with severe cerebrovascular diseases.