scholarly journals Effect of Early Enteral Nutrition Support on Nitrogen Balance and Nihss Score in Elderly Patients With Acute Cerebral Stroke and Dysphagia

Pteridines ◽  
2018 ◽  
Vol 29 (1) ◽  
pp. 91-96
Author(s):  
Gao Xiaorong ◽  
Shi Ning ◽  
Yuanfang Yao

AbstractThe aim of this study was to evaluate the clinical efficacy of early enteral nutrition support (EENS) on nitrogen balance and National Institute of Health stroke scale (NIHSS) in elderly patients with acute cerebral stroke and dysphagia. Sixty-eight patients diagnosed with acute brain stroke (ABS) were retrospectively analyzed in our hospital database. Of the included 68 ABS subjects, 37 patients were given early EENS within 72h after ABS diagnosis (experiment group) and the other 31 cases were given a regular liquid diet (control group). The nitrogen balance 1, 2, 3 and 4 weeks after EENS were -4.3 ± 1.3, -3.4 ± 1.1, -2.6 ± 1.2 and -2.0 ± 1.1(g/d) respectively for the experiment group and -8.5 ± 3.1, -7.0 ± 2.4, -6.2 ± 1.5 and -5.7 ± 1.1 (g/d) respectively for the control group. This indicated that the nitrogen balance in the experimental group was significantly higher than that of the control group (p<0.05). After treatment, the NIHSS score were 7.3 ± 2.3 and 7.4 ± 2.4 in the experimental and control groups respectively with statistically significant difference (p<0.05). The risk of developing regurgitation, diarrhea and ventosity in the experimental group were significantly lower than that of the control group (p<0.05). EENS can quickly improve the burden of ABS in elderly patients, elevate the nutritional level and reduce the risk of related complications.

2020 ◽  
Vol 185 ◽  
pp. 03018
Author(s):  
Jian Guo ◽  
Deqi Ren ◽  
Xuehui Chang

Objective: To explore the clinical effect of the combined use of Buyang Huanwu Decoction and acupuncture in the treatment of patients with sequelae of stroke. Methods: The research work was carried out in our hospital. The study started from September 2018 to September 2019. A total of 100 patients were selected and randomly grouped into experimental group and control group, both groups were given Buyang Huanwu Decoction for intervention, the experimental group were added acupuncture treatment methods on this basis to explore the clinical effects of different intervention methods. Results: There were 4 patients with ineffective treatment in the experimental group, the effective rate was 92.00%, and the effective rate in the control group was 74.00%. The effective rate of the experimental group was higher, and the data was significantly different (P<0.05). After treatment, the FMA, NIHSS score and Barthel index of the patients in the experimental group were (32.66±6.51), (7.11±3.54) and (90.34±9.87) respectively. The FMA score and Barthel index were significantly higher than the control group, and the NIHSS score was lower than the control group, data differences are significant (P<0.05). At the same time, before treatment, there was no significant difference in the scores of TCM syndromes. After treatment, the patients in the experimental group had less hemiplegia, skewed eyes and mouth, eccentric sensation abnormality and consciousness coma scores than that of the control group. The data difference is quite large (P<0.05), the experimental group had better effect. Conclusion: The combined treatment of Buyang Huanwu Decoction and acupuncture in the treatment of patients with sequelae of stroke has a significant clinical effect, which can improve the quality of life of patients, improve the nerve function of patients, and have a positive effect on clinical development.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Jun Xue ◽  
Yanan Zhang ◽  
Zhaohe Song ◽  
Lei Wang ◽  
Baoyin Bo

Aims:Objective to explore the influence of family enteral nutrition support on nutritional status, lung function, activity tolerance and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) in stable stage and malnutrition. Methods: a total of 165 elderly patients with COPD and malnutrition discharged from the geriatric department of our hospital were randomly divided into two groups: control group (82 cases) and observation group (83 cases). The control group was treated with conventional diet, and the observation group was treated with conventional diet + enteral nutrition suspension (nengjin, 500kcal / bottle, newdisia Pharmaceutical Co., Ltd.) for support. One month later, they were observed The body mass index (BMI), serum albumin (ALB), total protein (TP), hemoglobin (HB), pulmonary function of the two groups were observed: forced vital capacity (FVC), forced expiratory volume (FEV1) in the first second, FEV1 / FVC, FEV1% of the predicted value (FEV1%), exercise tolerance and quality of life.Results (1) compared with the control group, BMI and ALB in the observation group increased significantly (t = 10.465, 6.189, P < 0.05), TP and Hb had no significant change, and the difference was not statistically significant (t = 1.310, 1.302, P > 0.05). (2) compared with the control group, FVC, FEV1, FEV1 / FVC, FEV1% in the observation group increased, with statistical differences (t = 11.999, 19.654, 13.418, 16.924, P < 0.05). (3) compared with the control group, the quality of life symptom score, activity score, influence score and total score of the observation group decreased significantly (t = 15.303, 6.773, 23.600, 14.766, P < 0.05), and 6MWT increased significantly (t = 111.962, P < 0.05).Conclusion enteral nutrition support can improve the nutritional status, lung function, activity tolerance and quality of life of elderly patients with COPD in stable stage and malnutrition.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xin Huang ◽  
Lai Jiang ◽  
Shaojun Chen ◽  
Gang Li ◽  
Wanxi Pan ◽  
...  

Abstract Background Minimally invasive surgery has achieved good results in the treatment of cerebral haemorrhage.However, no large-scale clinical study has demonstrated that surgical treatment of cerebral haemorrhages less than 30 ml can improve the curative effect. Our study explored the efficacy and complication of stereotactic drainage based on the amount of cerebral hemorrhage (15-30 ml) in hypertensive basal ganglia. Method Sixty patients with hypertensive basal ganglia haemorrhages were divided into a control group and an experimental group with 30 patients in each group. Patients in the control group were treated conservatively. In contrast, those in the experimental group received stereotactic drainage, and urokinase was injected into the haematoma cavity after the operation. The haematoma volume at admission and 1, 3, 7 and 30 days after treatment and National Institute of Health stroke scale(NIHSS) score data were recorded. Complications after treatment in the two groups of data were compared and analysed. Result No significant differences in age, sex, time of treatment after onset, admission blood pressure, admission haematoma volume or admission NIHSS score were noted between these two groups (P > 0.05). After treatment, significant differences in haematoma volume were noted between the two groups on the 1st, 3rd, 7th and 30th days after treatment (P < 0.05). The amount of hematoma of patients in the experimental group was significantly reduced compared with that in the control group, and the NIHSS scores were significantly different on the 3rd, 7th and 30th days after treatment. The neurological deficit scores of patients in the experimental group were significantly reduced compared with those in the control group, and the incidence of pulmonary infection and venous thrombosis in the lower limbs of patients in the experimental group were significantly reduced (P < 0.05). ROC curve analysis showed that stereotactic drainage affected the early neurological function of patients with small and medium basal ganglia haemorrhages. Conclusion For patients with small and medium basal ganglia haemorrhages, stereotactic drainage can be used due to the faster drainage speed of haematomas after operation, which is beneficial to the recovery of neurological function and reduce complications.


Author(s):  
О.А. Осипова ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
Н.И. Клюшников ◽  
...  

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.


2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoye Wang

【Abstract】Objective: Toanalyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.METHODS:Sixty-six elderly patients with coronary heart disease and hypertension were enrolled from December 2017 to November 2018. They were randomly divided into two groups, 33 patients in each group. Patients in the experimental group received nifedipine. In combination with enalapril, patients enrolled in the control group received nifedipine monotherapy.RESULTS:Compared with the control group, the total effective rate, Serum Nitric Oxide (Serum NO) after treatment, CRP after treatment, HCY after treatment, and blood pressure after treatment were significantly improved (P<0.05). Serum NO and treatment before treatment in the 2 groups. There was no significant difference in pre-CRP, pre-treatment HCY, pre-treatment blood pressure, and adverse reactions during treatment (P>0.05).Conclusion: Theelderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.


2021 ◽  
Vol 104 (3) ◽  
pp. 482-488

Objective: To compare drug adherence with or without pharmaceutical pictograms in the elderly with chronic diseases. Materials and Methods: The present study was a randomized controlled trial conducted between April 2019 and June 2019 at a primary health care center in Hat Yai, Songkhla, Thailand. The elderly patients with chronic diseases were randomly allocated to the experimental group (n=25) and the control group (n=25). The experimental group received pictogram labels, text labels, and verbal information on the consumption of medications from the pharmacist. The control group received text labels and verbal information from the pharmacist. Both groups received follow-up home visits two weeks later. Results: The present study results showed that medication adherence using pill counts in the experimental group was significantly higher than in the control group. The median medication adherence scores from pill counts was (interquartile range, IQR) 100 (100, 100) versus 95.56 (90.25, 100), respectively, p=0.011. The medication adherence with the medication taking behavior measure for Thai patients (MTB-Thai) significantly increased in the experimental group (100.0%) compared with the control group (45.8%) (p=0.0002). Conclusion: The present study showed that medication adherence is greatly improved when the medication instruction is supplemented with pictograms. Therefore, medication should include pictograms on labels to better convey medical instructions to elderly patients with chronic diseases. Keywords: Pharmaceutical pictograms, Medication adherence, Chronic disease, Elderly patients


2014 ◽  
Vol 23 (5) ◽  
pp. 396-403 ◽  
Author(s):  
Friederike Compton ◽  
Christian Bojarski ◽  
Britta Siegmund ◽  
Markus van der Giet

BackgroundEarly enteral nutrition is recommended for patients in intensive care units, but nutrition provision is often hindered by a variety of unit-specific problems.ObjectivesTo evaluate the impact of a nutrition support protocol on nutrition prescription and delivery in the intensive care unit.MethodsNutrition-related data from 73 patients receiving mechanical ventilation who were treated in an adult medical intensive care unit before introduction of an enteral nutrition support protocol were retrospectively compared with data for 87 patients admitted after implementation of the protocol.ResultsAfter implementation of the protocol, enteral nutrition was started significantly earlier (P = .007) and enteral feeding goals were reached significantly faster (6 vs 10 days, P &lt; .001) than before. Prescription of enteral nutrition on the first day of invasive mechanical ventilation increased from 38% before to 54% after (P = .03) implementation of the protocol. Prescribed and delivered nutrition doses on the first 2 days of mechanical ventilation also increased significantly (P &lt; .001) after the protocol was implemented. Nasojejunal feeding tubes were used in 52% of patients before and 56% of patients after protocol implementation P = .63). Jejunal tubes were placed earlier after the protocol was implemented than before (median 5 vs 6.5 days), and when a jejunal tube was in place, feeding goals were reached faster (median 2 vs 3 days, P = .002).ConclusionImplementing an enteral nutrition support protocol shortened the time to reach feeding goals. Jejunal feeding tubes were necessary in more than half of the patients, and with a jejunal feeding tube in place, feeding goals were reached rapidly.


2018 ◽  
Vol 5 (1) ◽  
pp. 69-74
Author(s):  
Jing-Jing Chao ◽  
Ya-Zhuo Xue

Abstract Objective We aimed to explore the effect of a new health education model on continuous nursing care in elderly patients with diabetes mellitus who had undergone an operation for fracture. Methods Convenience sampling was used to select 59 elderly patients with diabetes mellitus and fracture. New health education methods were used, and patient parameters were evaluated before and after the intervention. Results Evaluation of medication, reasonable diet, regular exercise, blood glucose monitoring, and regular follow-up compliance were significantly improved in the experimental group compared to the control group (P < 0.05). There were also significant differences between groups in fasting blood glucose, 2-hour postprandial blood glucose, triglyceride, high-density lipoprotein, and low-density lipoprotein levels (P < 0.05); however, the differences between groups in terms of glycosylated hemoglobin and total cholesterol levels were not statistically significant (P > 0.05). Finally, the functional recovery and mental health of the experimental group were significantly better than those of the control group (P < 0.05). Conclusions The implementation of a menu of voluntary services in community-based continuous nursing provided standardized nursing care for elderly patients with fracture and diabetes mellitus and improved their quality of life.


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Dan Zhang ◽  
Hongli Li ◽  
Xiang Tian ◽  
Sujuan Zhang

Objectives: To evaluate the effect of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure and its clinical significance. Methods: Eighty patients with moderate and severe heart failure admitted to the Cardiology Intensive Care Unit (CCU) of Baoding First Central Hospital from May 2019 to May 2020 were included in this study and randomly divided into two groups: the experimental group and the control group, with 40 patients in each group. The experimental group was given enteral nutrition support therapy on the basis of conventional therapy for one month, while the control group was given restricted salt and water intake on the basis of conventional therapy, and patients were given free diet according to their wishes. The changes in heart function before and after treatment, changes in inflammatory factors such as TNF-a, CRP, IL-6, changes in levels of immunoglobulins such as IgA, IgM, and IgG, and the improvement of the performance status of the two groups were compared and analyzed. Results: After treatment, indicators such as BNP, LVEDD, LVEF and 6min walking distance in the experimental group were significantly improved compared with the control group, with statistically significant differences (p<0.05), and the levels of inflammatory factors such as TNF-a, CRP and IL-6 in the experimental group were significantly reduced compared with those in the control group (p=0.00). The levels of IgG, IgA, IgM and other immunoglobulins in the experimental group improved more significantly after treatment than those in the control group, with statistically significant differences (IgG, IgA, p=0.00; IgM, p=0.01). Moreover, the experimental group was significantly superior to the control group in the improvement rate of performance status score (ECOG) after treatment (p=0.04); The incidence of gastrointestinal adverse reactions in the experimental group was 20%, and that in the control group was 15%. No statistically significant difference can be observed in the gastrointestinal tolerance of both groups (p=0.56). Conclusions: Reasonable enteral nutrition boasts a variety of benefits for the recovery of elderly patients with chronic heart failure. With reasonable enteral nutrition, the heart function of elderly patients with chronic heart failure can be significantly improved, inflammatory factors can be reduced, immunity and performance status can be enhanced, and gastrointestinal tolerance can be ameliorated without obvious gastrointestinal reactions. doi: https://doi.org/10.12669/pjms.38.1.4451 How to cite this:Zhang D, Li H, Tian X, Zhang S. Effects of enteral nutrition on heart function, inflammatory markers and immune function in elderly patients with chronic heart failure. Pak J Med Sci. 2022;38(1):---------.  doi: https://doi.org/10.12669/pjms.38.1.4451 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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