Application of nasal duodenum combined with rhubarb in enteral nutritional support in patients with ICU coma

Abstract

Objective To investigate the effect of nasal duodenal canal combined with rhubarb on enteral nutrition support in patients with ICU coma. Methods A retrospective study was performed on 120 cases of patient with ICU coma who were admitted from April 2016 to April 2017.Patients were randomly divided into the combined intervention group and gastric tube intervention group, with 60 cases in each group.The nasal duodenal tube combined with rhubarb was given in the combined intervention group, while the gastric tube was used in the general gastric tube model.The observation time of patients in both groups was 1 week, and the time to stop enteral nutrition support, the use of gastric dynamic drugs, and the gastric residue were compared.Body mass, triceps cutaneous fold thickness(TSF), gluteal muscle circumference, albumin of the two groups before and after intervention were compared, and CD4+ , CD8+ , CD4+ /CD8+ and CD3+ levels were measured. Results Combined intervention group after the intervention, the patient's stomach residues was [(18.01±4.35)ml], the average gastric dynamic drug usage was [(4.22±0.75)ml], significantly less than the tube intervention group [(29.78±8.28)ml, (6.38±0.48)ml], stop enteral nutrition support [(49.65±15.96)hours] average time was significantly shorter than the tube intervention group [(62.36±29.94)hours], (P<0.05). The body mass and albumin of the patients in the combined intervention group were significantly increased, the mental and physical strength were significantly improved, and the subcutaneous fat layer was significantly thickened.Compared with the gastric tube intervention group, the difference was statistically significant(P<0.05). The number of abnormal cases of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ in the combined intervention group was lower than that in the gastric tube intervention group, and the difference was statistically significant(P<0.05). The levels of CD3+ , CD4+ and CD4+ /CD8+ in the combined intervention group were higher than those in the gastric tube intervention group and lower than those in the gastric tube intervention group(P<0.05). Conclusion Nasal duodenal tube combined with rhubarb can effectively promote the recovery of patients with ICU coma in enteral nutrition support, significantly reduce the amount of gastric residual and the average amount of gastric dynamic drug use, help and improve the nutritional status of patients, shorten the average time to stop enteral nutrition support, and promote the recovery of immune function of the body. Key words: Nasal duodenum; Rhubarb; ICU; Coma; Enteral nutrition support; Immune function