摘要
目的探讨益生菌早期肠内营养对重症颅脑损伤患者营养状况及免疫功能的影响。方法将遂宁市中心医院收治的96例重型颅脑损伤的患者,按照随机数字表法分为观察组(n=48)和对照组(n=48),对照组采用常规的留置胃管鼻饲进行肠内营养支持治疗,观察组在此基础上添加益生菌。干预2周后,评价两组患者治疗前后的血清白蛋白(serum albumin,ALB)、前白蛋白(prealbumin,PA)、转铁蛋白(transferrin,TRF)、血红蛋白(hemoglobin,Hb)、T淋巴细胞(CD3+、CD4+、CD4+/CD8+)、免疫球蛋白A (immunoglobulin A,IgA)、免疫球蛋白G (immunoglobulin G,IgG)、免疫球蛋白M (immunoglobulin M,IgM)、格拉斯哥昏迷评分(glasgow Coma Scale,GCS)、急性生理与慢性健康评分(acute physiology and chronic health evaluation,APACHEⅡ)、序贯器官功能衰竭评分(sequential organ failure assessment,SOFA)情况。结果治疗后观察组体液免疫指标IgA、IgG、IgM,细胞免疫指标CD3^+、CD4^+、CD4^+/CD8^+,营养指标ALB、PA、TRF和Hb明显高于对照组,差异具有统计学意义(t=0.821~13.829,P<0.05)。观察组GCS评分、APACHEⅡ评分、SOFA评分结果明显优于对照组,差异具有统计学意义(t=3.489~4.041,P<0.05)。观察组感染发生率为14.58%(7例),对照组感染发生率为37%(18例),差异具有统计学意义(χ2=6.541,P=0.01)。结论益生菌早期肠内营养能提高重型颅脑损伤患者营养状况及免疫功能,改善患者的预后。
Objective To investigate the effect of early enteral nutrition of probiotics on nutritional status and immunity in patients with severe craniocerebral injury.Methods 96 patients with severe craniocerebral injury admitted to central hospital of Suining city from April 2017 to June2018 were divided into the observation group(n=48) and the control group(n=48) according to the random number table method.The control group was treated with conventional indwelling gastric tube nasogastric feeding for enteral nutrition support treatment,and the observation group was added with probiotics on this basis.2 weeks after the intervention,serum albumin(ALB) and prealbumin(PA),transferrin(TRF),hemoglobin(Hb),T lymphocyte(CD3^+,CD4^+,CD4^+/CD8^+),Immunoglobulin A(IgA),Immunoglobulin G(IgG),Immunoglobulin M(IgM),Glasgow coma scale(GCS),acute physiology and chronic health evaluation(APACHE Ⅱ),sequential organ failure score(SOFA) of two groups before and after treatment were evaluated.Results After treatment,the humoral immune indexes IgA,IgG,IgM,cellular immune indexes CD3+,CD4+,CD4+/CD8+,nutritional indexes ALB,PA,TRF and Hb in the observation group were significantly higher than those in the control group(t=0.821~13.829,P <0.05).The GCS score,Apache Ⅱ score and SOFA score in the observation group were significantly better than those in the control group(t=3.489~4.041,P<0.05).The incidence of infection was 14.58%(7 cases) in the observation group and 37%(18 cases) in the control group,the difference was statistically significant(χ2=6.541,P=0.01).Conclusion Early enteral nutrition of probiotic can improve the nutritional status and immunity of patients with severe craniocerebral injury,and improve the prognosis of patients.
作者
包红梅
伍小芝
王秀华
李红
Bao Hongmei;Wu Xiaozhi;Wang Xiuhua;Li Hong(Intensive Care Uni,Central Hospital of Suining City,Suining 629000,China)
出处
《心脑血管病防治》
2020年第2期172-175,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
益生菌
早期肠内营养
重型颅脑损伤
营养状况
免疫功能
Probiotics
Early enteral nutrition
Severe craniocerebral injury
Nutritional status
Immunity
