Abstract
Background: Critically ill stroke patients often have dysphagia, which prevents them from taking in nutrients normally. In addition, they are in a prolonged state of high stress, high metabolism and low immunity, and early enteral nutrition support plays an important therapeutic role. However, food intolerance often occurs during feeding.
Objective: To investigate the effect of fine management of enteral nutrition on nutritional status and nutritional intolerance in critically ill stroke patients.
Methods: A convenience sampling method was used to retrospectively collect 81 critically ill stroke patients hospitalized in our department from January 2021 to December 2021 as the control group, and 81 critically ill stroke patients hospitalized in our department from January 2022 to December 2022 were selected as the observation group. The control group was given daily nutritional management, and the observation group implemented enteral nutrition refinement management, comparing the nutritional status (including serum albumin, hemoglobin, triceps skinfold thickness, and triceps muscle circumference of the upper arm on the nonparalyzed side), the incidence of feeding intolerance, acute physiological and chronic health (APACHE II) score, and the efficiency of refinement management at the time of admission and before discharge in both groups.
Results: After refined management, serum albumin [(40.69±1.88) vs. (38.92±1.21)g/L；t=-7.147，p=0.000] and hemoglobin [(114.40±8.00)vs.(110.57±6.52)g/L；t=-3.337，p=0.001] values in the observation group were higher than those in the control group, triceps skinfold thickness [(12.29±2.0) vs. (11.20±2.40）mm；t=-3.087，p=0.002] and triceps muscle circumference [(21.11±1.47) vs. (19.86±1.65)cm,t=-5.068，p=0.000] levels of the upper arm on the nonparalyzed side were higher than those of the control group (p < 0.05), the incidence of enteral nutrition intolerance was lower than that of the control group (p < 0.05), and the APACHE II score [(15.06±2.89) vs. (19.85±3.36) points, t=9.236，P=0.000] was lower than that of the control group (p < 0.05).
Conclusion: Refined management of enteral nutrition not only improves the nutritional status of patients but also prevents the occurrence of feeding intolerance in critically ill stroke patients, which is beneficial to the disease recovery and prognosis of critically ill stroke patients.