早期应用含膳食纤维的肠内营养与全肠外营养对重型颅脑损伤患者肠黏膜屏障的影响比较  

Effects of early application of dietary fiber and parenteral nutrition support on the the intestinal barrier in severe brain injury patients

作　　者：赵永华[1] 杨开敏[1] 贾秀艳[1] 晁怀宇[1] 孟伟[1] 

机构地区：[1]河北省廊坊市人民医院重症医学科,065000

出　　处：《实用医学杂志》2013年第21期3508-3510,共3页The Journal of Practical Medicine

基　　金：河北省廊坊市科技支撑计划项目(编号:2012013007)

摘　　要：目的:评价早期应用含有膳食纤维的肠内营养与早期应用肠外营养对重型颅脑损伤患者肠黏膜屏障的影响。方法:选取100例重型颅脑损伤患者随机分为膳食纤维+肠内营养组和肠外营养组,每组50例,膳食纤维+肠内营养组早期给予含有膳食纤维的肠内营养,肠外营养组给予全肠外营养,第1、5、9天分别测定血浆二胺氧化酶含量、D乳酸含量及血浆内毒素水平和尿乳果糖排泄率。结果:对比肠外营养组,膳食纤维+肠内营养组治疗1、5、9 d后测血浆二胺氧化酶含量、D乳酸含量、血浆内毒素水平及尿乳果糖排泄率较肠外营养组低,且差异有统计学意义(P<0.05)。结论:早期应用含有膳食纤维的肠内营养对重型颅脑损伤患者肠黏膜屏障具有保护作用,优于肠外营养,应首选肠内营养途径。Objective To study the effects of early application of dietary fiber and parenteral nutrition support on the intestinal barrier in the severe brain injury patients. Methods One hundred patients undergoing severe head injury were divided into enteral nutrition group and parenteral nutrition group randomly. The patients in enteral nutrition group were given enteral nutrition containing dietary fiber, and the patients in parenteral nutrition group were treated with total parenteral nutrition after trauma, Plasma DAO, D-lactate acidosis, endotoxin level and the excretory ratio of lactulose and mannitol in urine were determined at the l, 5 and 9 days after trauma respectively. Results Compared to parenteral nutrition group, the levels of plasma DAO, D-lactate acidosis, endotoxin and the excretory ratio of lactulose and mannitol in urine were downregulated in enteral nutrition group （P 〈 0.05）. Conclusion Early application of enteral nutrition containing dietary fiber in patients with severe brain injury has a protective effect of intestinal mucosal, better than parenteral nutrition.

关 键 词：颅脑损伤 肠外营养 肠内营养 肠黏膜屏障 

分 类 号：R651.15[医药卫生—外科学]