Clinical analysis of enteral nutrition therapy in the treatment of complications of Crohn′s disease

Abstract

Objective To investigate the therapeutic value of enteral nutrition in disease activity, nutritional status and complications of patients with Crohn′s disease (CD). Methods From January 2015 to February 2017, 64 CD patients with malnutrition in the First Affiliated Hospital of Soochow University were selected and received basic treatment with enteral nutrition. Before enteral nutrition and three months after therapy, white blood cell (WBC), red blood cell (RBC), hemoglobin, platelet, total protein, albumin, erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) were examined; Crohn′s disease activity index (CDAI) was calculated; abdominal and perianorectal lesions of patients were observed by small intestinal computed tomography (CT), abdominal ultrasound and anus magnetic resonance imaging (MRI). Paired t test and McNemar test were performed for statistical analysis. Results Compared with those before enteral nutrition treatment, who received enteral nutrition for three months, the levels of WBC, platelet, ESR, CRP and CDAI scores of CD patients were lowered ((7.83±3.61)×109/L vs. (4.82±2.26)×109/L, (272.52±191.79)×109/L vs. (166.17±67.18)×109/L, 33.5 mm/1 h vs. 5.5 mm/1 h, 21.70 mg/L vs. 1.97 mg/L, 220.75±119.71 vs. 33.48±20.22), and the differences were statistically significant (t=13.14 and 10.02; Z=501.50 and 57.80; t=25.44, all P<0.01). The levels of RBC, hemoglobin, total protein, albumin increased ((4.17±0.97)×1012/L vs. (4.97±0.98)×1012/L, (115.33±40.38) g/L vs. (133.88±43.87) g/L, (57.82±19.46) g/L vs. (69.68±16.53) g/L, (34.32±16.85) g/L vs. (43.29±17.57) g/L), and the differences were statistically significant (t=-10.45, -7.12, -11.44 and -6.87, all P<0.01). The CDAI scores of patients with remission of abdominal pelvic diseases and intestinal stenosis were both lower than those of patients without remission (214.3±113.54 vs. 296.77±60.24, 219.31±104.74 vs. 221.04±121.47), and the differences were statistically significant (both t=28.91, both P<0.05). Three months after enteral nutrition treatment, the remission patients of perianal lesions, abdominal pelvic diseases and intestinal stenosis were 28, 14 and 18 cases, respectively. Conclusion CD patients can achieve clinical remission with enteral nutrition treatment, which also prevent and treat CD related malnutrition and may prove to be a safe and first-line therapeutic approach. Key words: Crohn disease; Enternal nutrition; Perianal lesions; Abdominal pelvic lesions; Stenosis; Clinical significance