فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: Malnutrition and excessive inflammation are common in elderly patients with femoral neck fractures and may impair postoperative fracture healing.The aim of this study is to investigate the effects of early enteral nutritional support on the dynamic levels of inflammatory factors in patients with femoral neck fractures.    Methods: This prospective observational cohort study included 115 patients with femoral neck fractures. Patients were divided into two groups: the early enteral nutrition group (EN group, n=61) and the conventional treatment group (n=54). Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of cytokines. ROC curve analysis was used to evaluate the predictive value of inflammatory factors for delayed healing, and logistic regression was used to identify independent risk factors associated with delayed healing.   Results: After 72 hours of nutritional intervention, the EN group showed significantly higher serum albumin (35.90±4.67 g/L vs. 31.68±3.36 g/L, P<0.001), higher total protein (64.01±5.95 g/L vs. 61.57±5.60 g/L, P=0.026), lower visual analog scale (VAS) scores (1.70±0.29 vs. 2.21±0.31, P<0.001), and a lower proportion of delayed healing (8.2% vs. 29.6%, P<0.001) compared to the conventional treatment group. From the second day after surgery, serum levels of IL-6, IL-8, and IL-17 were significantly lower in the EN group at multiple time points. ROC curve analysis showed that IL-17 had the highest predictive value for delayed healing (AUC=0.793, cutoff=55.67 pg/ml, sensitivity=76.2%, specificity= 63.8%).    Conclusion: We found that early enteral nutrition support significantly improved nutritional markers, reduced inflammatory responses, and reduced the proportion of patients with delayed healing in femoral neck fractures.