Objective?To explore the effects of early enteral nutrition (EEN) combined with supplementary parenteral nutrition (SPN) in acute ischemic stroke elderly patients after mechanical embolectomy. Methods?From October 2015 to June 2017, we retrospectively collected 35 acute ischemic stroke elderly patients treated with nutritional support after mechanical embolectomy. All of the patients were divided into alone EEN group (n=9) and EEN+SPN group (n=26) according to whether to accept SPN or not. We analyzed the clinical data and curative effects, and summarized nutritional monitoring indexes such as the hemoglobin (HGB), total protein (TP), total lymphocyte count (TLC), serum albumin (ALB) before and one, two weeks after surgery and compared the incidence of complications such as pulmonary infection, diarrhea, gastrointestinal hemorrhage as well as average hospital day, hospitalization expenses, outcome of disease. Results?There were 24 patients who were cured and discharged from hospital and two patients who were fatal in EEN+SPN group. There were 9 patients who were cured and discharged from hospital. There was no significant difference in HGB, TP, TLC, ALB between two groups before and after surgery (P＞0.05). The difference in ALB of EEN group two weeks after surgery was significant which was compared with that before surgery (P＜0.05). The incidence of pulmonary infection, diarrhea, gastrointestinal hemorrhage of EEN+SPN group was 65.38%, 19.23%, 11.54% respectively with no significant difference with those of EEN group (P＞0.05). There was no significant difference in average hospital day and hospitalization expenses between EEN+SPN group [(22.94±12.91)d, (12.53±4.98) ten thousand yuan, respectively]and EEN group (P＞ 0.05). Conclusions?The application of alone EEN in acute ischemic stroke elderly patients after mechanical embolectomy may easily cause that the level of ALB decreases. The EEN+SPN may be applied according to patient's condition so as to prevent hypoproteinemia and improve the nutritional state.

Objective:To explore the effects of Donabedian's structure-process-outcome three-dimensional quality evaluation model in the quality management of daytime surgery for patients undergoing digital subtraction angiography (WBDSA) .Methods:The patients who underwent daytime DSA at Ningbo First Hospital in Zhejiang Province from October 2019 to October 2020 were selected as the research subjects, with 61 patients admitted from October 2019 to April 2020 included into a control group, and 65 patients admitted from May to October 2020 included into an observation group. Patients in the control group received routine daytime operation management, while patients in the observation group underwent daytime operation management based on a structure-process-outcome three-dimensional quality evaluation model. The incidence of complications, ≥ 2 times reexamination rate and patient satisfaction were compared between the two groups.Results:There was no significant difference in the incidence of complications at the puncture site and non-puncture site between the two groups ( P>0.05) . The rate of ≥ 2 reexamination in the observation group was 21.54% (14/65) , which was higher than 8.20% (5/61) in the control group, and the difference was statistically significant ( P<0.05) . The patient satisfaction in the observation group was (99.04±2.10) , which was higher than (96.93±2.95) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The daytime operation management model based on Donabedian three-dimensional quality evaluation model can improve the compliance of reexamination and satisfaction of patients undergoing DSA.

Objective To explore the eternal nutrition support impacted on postoperative result of severe craniocerebral injury patients. Methods A total of 258 patients with severe craniocerebral injury patients were collected and divided into early enteral nutrition ( EEN ) group ( n =128 ) and delay enteral nutrition ( DEN) group ( n =130 ) . The postoperative infection rate, length of hospitalization and expenditure were compared between the two groups. Results The infection rates were 43. 75% (56/128), 43. 85% (57/130) in EEN group and DEN group, while the length of hospitalization were (18. 86 ± 4. 51), (19. 21 ± 5. 91)d, total costs (54 914 ± 2 493. 1) and (55 107 ± 3 443. 9) Yuan in two groups without statistical significance (P>0. 05). Conclusions Strengthening nutrition support does not impact on patients recovery within 48h or 72h severe craniocerebral injury, but early nutrition support has certain benefits for body metabolism, body resistance, infection rate and rehabilitation of prognosis.