摘要
目的探讨早期肠内营养联合双歧杆菌治疗急诊消化道穿孔的临床疗效。方法选取自2015年6月至2019年1月在池州市人民医院急诊外科接受手术治疗的80例急性消化道穿孔患者为研究对象,分为常规组与观察组,每组40例。观察组实施早期肠内营养(术后24 h内启动肠内营养)并联合应用双歧杆菌,常规组实施延迟肠内营养(术后24 h后启动肠内营养)并联合应用双歧杆菌。测定两组患者术前及术后1周的白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)等炎症指标及白蛋白(ALB)、血红蛋白(Hb)、前清蛋白(PA)等营养指标。记录两组患者术后的机械通气时间、肛门排气时间、ICU入住时间、住院时间、住院费用及并发症发生率。结果两组患者术后1周的IL-6、hs-CRP均较术前显著降低,ALB、Hb、PA均较术前显著升高,差异均有统计学意义(P<0.05)。观察组术后1周的IL-6、hs-CRP水平显著低于常规组,ALB、Hb、PA均显著高于常规组,差异均有统计学意义(P<0.05)。观察组患者术后的机械通气时间、肛门排气时间、ICU入住时间、住院时间均明显短于常规组,住院费用及感染性并发症总发生率低于常规组,差异均有统计学意义(P<0.05)。结论早期肠内营养支持联合双歧杆菌能有效促进消化道穿孔患者胃肠功能,改善机体营养状况,减轻炎症反应,降低感染风险,加快患者康复进程。
Objective To investigate the clinical efficacy of early enteral nutrition combined with bifidobacteria in the treatment of emergency digestive tract perforation.Methods A retrospective study was performed on 80 cases on patients with acute digestive tract perforation who were admitted from June 2015 to January 2019.Patients were divided into the conventional group and the observation group,with 40 cases in each group.The observation group of patients received early enteral nutrition(started enteral nutrition within 24 hours after surgery)and combined application of bifidobacteria,while the conventional group received delayed enteral nutrition(started enteral nutrition within 24 hours after surgery)and combined application of bifidobacteria.Inflammatory indicators such as interleukin(IL-6),hypersensitive C-reactive protein(hs-CRP)and nutritional indicators such as albumin(ALB),hemoglobin(Hb)and prealbumin(PA)were measured before and 1 week after the operation.Postoperative mechanical ventilation time,anal exhaust time,ICU admission time,length of stay,hospitalization cost and complication rate were recorded.Results IL-6,hs-CRP and ALB,Hb and PA in the two groups one week after surgery were significantly lower than those before surgery,and the differences were statistically significant(P<0.05).Moreover,IL-6 and hs-CRP levels in the observation group one week after surgery were significantly lower than those in the conventional group,while ALB,Hb and PA levels in the observation group were significantly higher than those in the conventional group(P<0.05).The postoperative mechanical ventilation time,anal exhaust time,ICU admission time and hospitalization time in the observation group were significantly shorter than those in the conventional group,and the hospitalization cost and the total incidence of infectious complications were lower than those in the conventional group(P<0.05).Conclusion Early enteral nutrition support combined with bifidobacteria in patients with emergency gastrointestinal perforation can effectively promote the recovery of gastrointestinal function,improve the nutritional status of the body,reduce the inflammatory response,reduce the risk of infection,and accelerate the recovery process.
作者
李金卫
余结根
LI Jin-wei;YU Jie-gen(Department of Emergency Surgery,Chizhou People’s Hospital,Chizhou 247100,China)
出处
《创伤与急危重病医学》
2020年第2期81-84,共4页
Trauma and Critical Care Medicine
基金
安徽高校省级科学研究项目(SK2018A0190)。
关键词
消化道穿孔
双歧杆菌
早期肠内营养
Digestive tract perforation
Bifidobacteria
Early enteral nutrition
作者简介
第一作者:李金卫(1984-),男,安徽安庆人,主治医师。
