Application of bedside ultrasonography combined with enteral nutrition tolerance score in nutritional support for elderly patients with hemorrhagic stroke

Lin Jianping; Li Juan; Chen Shan; Tang Yunzhen; Wang Minhan; Cao Lijun; Li Qi

doi:10.11850/j.issn.1009-122X.2024.11.011

Abstract：Objective To explore the effect of bedside ultrasonography combined with enteral nutrition tolerance score in guiding nutritional support therapy for elderly patients with hemorrhagic stroke. Methods A total of 80 elderly patients with hemorrhagic stroke were randomly divided into a control group and a study group,with 40 patients in each group. The control group received enteral nutrition support therapy guided by the enteral nutrition tolerance score. The study group received enteral nutrition support therapy guided by both the antral motility index (MI) and enteral nutrition tolerance score,with MI obtained via bedside ultrasonography along with gastric residual volume. The two groups were compared in terms of 7-d enteral nutrition feeding amount,target feeding rate and enteral nutrition complications,and nutritional indicators,the National Institutes of Health Stroke Scale (NIHSS) scores,and Glasgow coma scale (GCS) scores at admission and on the 5th and 10th day of hospitalization. Results The mean 7-day enteral nutrition feeding calorie intake and 7-day target feeding rate were (72.05±12.18) kJ/(kg·d) and 90.0％,respectively,in the study group,and (60.74±14.92) kJ/(kg·d) and 70.0％,respectively,in the control group,with significantly higher values in the study group (P<0.05). The target feeding time and feeding intolerance interruption times were (72.43±16.58) h and (1.75±0.35) times,respectively,in the study group,and (92.18±24.84) h and (3.17±0.85) times,respectively,in the control group,with significantly fewer values in the study group (P<0.05). The levels of serum total protein (TP),albumin (Alb),and prealbumin (PA) on the 5th and 10th days of hospitalization were significantly higher in the study group than in the control group (all P<0.05). The NIHSS scores on the 5th and 10th days of hospitalization were significantly lower,and GCS scores were significantly higher,in the study group than in the control group (all P<0.05). The overall incidence of gastrointestinal complications was significantly lower in the study group than in the control group (P<0.05). Conclusions Individualized enteral nutrition support program based on bedside ultrasonography combined with enteral nutrition tolerance score can significantly shorten the target feeding time,reduce enteral nutrition complications,improve nutritional status,alleviate neurological damage,and improve prognosis in elderly patients with hemorrhagic stroke.