早期肠内营养联合益生菌对重型颅脑损伤患者术后感染的影响研究  

Influence of early enteral nutrition combined with probiotics on postoperative infections in patients with severe traumatic brain injury

作　　者：陈露萍[1] 刘维群[1] 程军[2] 

机构地区：[1]杭州师范大学附属医院营养科,浙江杭州310015 [2]杭州师范大学附属医院神经外科,浙江杭州310015

出　　处：《中华医院感染学杂志》2015年第6期1357-1359,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(ZW-2010B-028)

摘　　要：目的探讨早期肠内营养联合益生菌对重型颅脑损伤患者术后感染的影响,以降低感染率。方法选取重型颅脑损伤手术患者110例,随机分为两组,对照组53例给予早期肠内营养治疗,观察组57例在对照组基础上给予益生菌联合应用,对两组患者住院期间发生感染进行统计,采用SPSS13.0软件进行分析。结果患者发生肺部感染率及总感染率观察组分别为19.30%及31.58%、对照组分别为30.19%及47.17%,观察组均明显低于对照组;治疗7d时观察组患者白细胞计数为(9.88±1.05)×109/L,7、15d时C-反应蛋白分别为(80.47±7.92)、(19.79±2.20)mg/L,对照组分别为(12.20±1.19)×109/L及(175.58±20.05)、(77.39±9.30)mg/L;治疗15d时患者GCS评分观察组为(12.43±1.97)分、对照组为(9.18±0.63)分;住院时间观察组为(6.40±0.95)d、对照组为(12.17±1.82)d;患者病死率观察组为14.04%、对照组为35.85%,两组差异均有统计学意义(P<0.05)。结论对重型颅脑损伤患者在早期肠内营养的基础上给予益生菌联合应用有利于降低感染发生率,改善患者预后。OBJECTIVE To observe the influence of early enteral nutrition combined with probiotics on postopera-tive infections in patients with severe traumatic brain injury so as to reduce the infection rate .METHODS A total of 110 patients with severe traumatic brain injury who underwent the surgery were enrolled in the study and randomly divided into two groups ;53 cases in the control group received the early enteral nutrition therapy ,while 57 cases in the observation group received the probiotics combination therapy based on the control group ;the incidence of infections during the hospital stay was statistically analyzed by using SPSS 13 .0 software .RESULTS The incidence rate of pulmonary infections was 19 .30% in the observation group ,significantly lower than 30 .19% in the control group ;the total infection rate of the observation group was 31 .58% ,significantly lower than 47 .17% of the con-trol group .At 7 days of the treatment ,the white blood cells counts were （9 .88 ± 1 .05） × 109 /L in the observation group ,（12 .20 ± 1 .19） × 109 /L in the control group ;the C-reactive protein level was （80 .47 ± 7 .92）mg /L in the observation group ,（175 .58 ± 20 .05）mg/L in the control group ;the C-reactive protein level of the observation group was （19 .79 ± 2 .20）mg/L at 15 days of the treatment ,the control group （77 .39 ± 9 .30）mg/L .At 15 days of the treatment ,the GCS score was （12 .43 ± 1 .97）points in the observation group ,（9 .18 ± 0 .63）points in the control group .The length of hospital stay was （6 .40 ± 0 .95）days in the observation group ,（ 12 .17 ± 1 .82）days in the control group .The mortality rate of the observation group was 14 .04% ,the control group 35 .85% ,there was significant difference between the two groups （P〈 0 .05） .CONCLUSION The early enteral nutrition combined with probiotics may contribute to the reduction of incidence of infections in the patients with severe traumatic brain injury and improve the prognosis of the patients .

关 键 词：早期肠内营养 益生菌 重型颅脑损伤 手术 感染 

分 类 号：R619.3[医药卫生—外科学]