Effect of sequential enteral nutrition support on elderly patients with severe ischemic stroke after thrombectomy

序贯肠内营养支持对血栓切除术后重度缺血性卒中老年患者的影响

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Abstract

OBJECTIVE: To explore the effects of sequential enteral nutrition support in elderly patients with severe ischemic stroke after thrombectomy. METHODS: From January 2022 to January 2024, 115 elderly patients with severe ischemic stroke who underwent thrombectomy were selected and divided into a control group (n = 57) and an intervention group (n = 58). The control group received routine enteral nutrition support, while the intervention group received sequential enteral nutrition support. The nutritional status, immune function, degree of neurological impairment, prognosis, daily living ability, gastrointestinal dysfunction, and incidence of complications were compared between the two groups. RESULTS: Compared with the control group, the intervention group had higher levels of albumin (ALB), total protein (TP), prealbumin (PA), and hemoglobin (Hb) on the 14th day after intervention (p < 0.05), higher levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) on the 14th day after intervention (p < 0.05), lower NIHSS score after 14 days of intervention, higher Glasgow Coma Scale (GCS) score, higher Barthel Index (BI) at discharge (p < 0.01), lower gastrointestinal dysfunction score on the 14th day after intervention (p < 0.05), and lower complication rate (p < 0.05). CONCLUSION: Sequential enteral nutrition support can attenuate the deterioration of intestinal adaptability under pathological conditions, promote the absorption of nutrients, and slow the decline of nutritional status in elderly patients with severe ischemic stroke after thrombectomy in the short term. It also shows early functional benefits, such as mitigating the worsening of the GCS and NIHSS scores at 14 days and the BI at discharge, and reducing the occurrence of short-term complications. Additionally, it appears to decelerate the decline of cellular and humoral immune parameters. These short-term physiological and early functional modifications create favorable conditions for the initial treatment and early rehabilitation of the diseases.

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