Effect of Enteral Nutrition Support through Percutaneous Endoscopic Gastrojejunostomy Tube on Immune Function, Endocrine Function and Prognosis in Patients with Severe Craniocerebral Injury

Yong Deng; Danna Fang; Jie Yan

Authors

Yong Deng Department of Neurosurgery, The 903rd Hospital of Joint Logistics Support Force,310000, Hangzhou, Zhejiang, China Author
Danna Fang Emergency Department, 903rd Hospital of the United Nations Logistics and Security Forces，Zhejiang, China. Author
Jie Yan Department of Respiratory Medicine, 903rd Hospital, 310000 Hangzhou, Zhejiang, China Author

Keywords:

Fibrinogen, Homocysteine, Uric acid, Type 2 diabetes mellitus, Cerebral infarction

Abstract

Objective To explore the effects of enteral nutrition support through percutaneous endoscopic gastrojejunostomy (PEG-J) tube on immune function, endocrine function and prognosis of patients with severe craniocerebral injury, so as to improve nutritional status of patients more effectively. Methods 65 patients with severe craniocerebral injury treated in our hospital from Jun. 2018 to Oct. 2020 were selected, and divided into control group (n=26) and observation group (n=39). Control group was treated with intranasal or oral indwentional gastric tube. Observation group received percutaneous endoscopic gastrojejunostomy. The dosages of propofol and fentanyl before 7 d, the levels of immune (CD₄⁺,CD₈⁺, CD₄⁺/CD₈⁺ratio) and endocrine function indicators (thyroid stimulating hormone (TSH), free T3 (F-T3), free T4 (F-T4)) on the 1st d and 7th d of treatment and prognosis (28 d mortality, duration of mechanical ventilation, duration of ICU, and incidence of ventilator-associated pneumonia (VAP)) were compared between the two groups. Results No significant difference existed in the dosages of propofol and fentanyl between the two groups before 7 d of treatment. On the 1st d of treatment, CD₄⁺, CD₈⁺and CD₄⁺/CD₈⁺ levels barely differed between the two groups, but obviously reduced after 7 d of treatment, with CD₄⁺ and CD₄⁺/CD₈⁺ levels evidently higher in observation group than in control group, and similar CD₈⁺level in the two groups. The similar trends were observed on the serum levels on the 1st d of treatment and the 7^th d of treatment. Conclusion PEG-J enteral nutrition support therapy has a good effect on patients with severe craniocerebral injury through relieving pain and restless symptoms, and improving immune and endocrine functions, with better prognosis.