Comparison of the clinical effects of early enteral and parenteral nutrition support in patients with severe stroke

Abstract

Objective To compare the clinical effects of early enteral and parenteral nutrition support in patients with severe stroke. Methods From June 2017 to July 2018, 65 patients with severe stroke admitted in the First People's Hospital of Yongkang were selected in the study, and the patients were randomly divided into control group(32 cases) and observation group(33 cases) according to the digital table.The control group received early parenteral nutrition support, while the observation group received early enteral nutrition support.The nutritional index, biochemical index, NIHSS score, CPIS score of clinical pulmonary infection and the incidence of complications were compared between the two groups. Results After nutritional support, the serum levels of total protein(TP), albumin(Alb), hemoglobin(Hb) in the observation group were (57.01±2.59)g/L, (39.98±2.64)g/L, (126.86±10.75)g/L, respectively, which were significantly higher than those in the control group [(54.28±0.76)g/L, (37.31±2.35)g/L, (120.75±13.46)g/L](t=5.727, 4.302, 2.025, all P<0.05). The serum levels of glucose(GLU), creatinine (SCr), alanine aminotransferase (ALT) in the observation group were (12.35±2.38)mmol/L, (84.37±13.62)μmol/L, (47.84±4.03)U/L, respectively, which were lower than those in the control group [(14.18±2.37)mmol/L, (91.84±13.21)μmol/L, (66.28±3.76)U/L] (t=3.106, 2.244, 19.060, all P<0.05). The levels of triglyceride(TG), serum urea nitrogen(BUN) in the observation group were (1.95±0.45)mmol/L, (5.80±0.61)mmol/L, respectively, which were higher than those in the control group [(1.66±0.30)mmol/L, (5.32±0.43)mmol/L] (t=0.341, 3.656, all P<0.05). The scores of NIHSS and CPIS in the observation group were (10.31±2.10)points and (3.00±0.76)points, respectively, which were lower than those in the control group [(14.68±2.75)points, (3.79±1.45)points](t=5.279, 2.763, P=0.001, 0.008). The incidence of complications in the observation group [9.38%(3/33)] was lower than that in the control group [31.25%(10/32)], and the difference was statistically significant(χ2=4.986, P<0.05). Conclusion Compared with early parenteral nutrition support, early enteral nutrition support can improve the nutritional status of patients with severe stroke and is safe and effective. Key words: Stroke; Enteral nutrition; Parenteral nutrition; Nutritional support; Albumins; Serum albumin; Hemoglobins; Comparative effectiveness research