益生菌联合早期肠内营养对重型颅脑损伤病人生化及营养等指标的影响  

IMPACT OF PROBIOTICS COMBINED WITH EARLY ENTERAL NUTRITION ON BIOCHEMICAL AND NUTRITIONAL PARAMETERS IN PATIENTS WITH SEVERE CRANIOCEREBRAL INJURY

作　　者：石婷婷 张学广[1] 焦盈盈[1] 任春会 侯磊[1] 种宗雷[1] SHI Tingting;ZHANG Xueguang;JIAO Yingying;REN Chunhui;HOU Lei;CHONG Zonglei(Brain Hospital, People＇s Hospital of Liaocheng, Liaocheng 252000, Chin)

机构地区：[1]聊城市人民医院脑科医院,山东聊城252000

出　　处：《齐鲁医学杂志》2017年第5期561-563,566,共4页Medical Journal of Qilu

摘　　要：目的探讨益生菌联合早期肠内营养对重型颅脑损伤病人生化及营养等指标的影响。方法将165例重型颅脑损伤病人随机分为普通鼻饲组42例(A组)、添加益生菌鼻饲组39例(B组)、鼻肠管鼻饲组43例(C组)和添加益生菌鼻肠管鼻饲组41例(D组),在摄入同等热量及同等氮量的条件下,分别于第1、7、14天行血清清蛋白(ALB)、血红蛋白(Hb)等营养指标的检测,同时比较各组胃肠道功能及并发症发生率等指标的变化。结果第14天,对比4组病人的ALB结果显示,B组优于A组(t=3.32,P<0.05),D组优于C组(t=2.75,P<0.05);Hb水平B组优于A组(t=3.25,P<0.05),D组优于C组(t=2.99,P<0.05);格拉斯哥昏迷评分(GCS)B组优于A组(t=3.40,P<0.05),D组优于C组(t=2.51,P<0.05);白细胞计数B组低于A组(t=3.21,P<0.05),D组低于C组(t=3.42,P<0.05);C反应蛋白水平B组低于A组(t=3.01,P<0.05),D组低于C组(t=3.65,P<0.05);降钙素原水平B组低于A组(t=2.31,P<0.05),D组低于C组(t=2.46,P<0.05)。腹胀、腹泻、反流等胃肠道症状反应的发生率B组低于A组(χ~2=3.98,P<0.05),D组低于C组(χ~2=4.11,P<0.05)。结论益生菌联合肠内营养能有效保护重型颅脑损伤病人的胃肠黏膜,减少胃肠道并发症。Objective To investigate the impact of probiotics combined with early enteral nutrition on biochemical and nutritional parameters in patients with severe craniocerebral injury.Methods A total of 165 patients with severe craniocerebral injury were randomly divided into four groups：routine nasogastric feeding group（group A;n=42）,nasogastric feeding with probiotics group（group B;n=39）,nasointestinal tube feeding group（group C;n=43）and nasointestinal tube feeding with probiotics group（group D;n=41）.With the same intake of calories and nitrogen,the nutritional parameters such as serum albumin（ALB）and hemoglobin（Hb）were determined on the 1 st,7 th,and 14 th days.Meanwhile,the changes in gastrointestinal function and complication incidence in each group were monitored and compared.Results On the 14 th day of treatment,group B had a significantly greater improvement in ALB than group A（t=3.32,P〈0.05）;group D had a significantly greater improvement than group C（t=2.75,P〈0.05）.Similarly,group B had a significantly higher increase in Hb than group A（t=3.25,P〈0.05）;group D had a significantly higher increase than group C（t=2.99,P〈0.05）.Group B had a significantly more improvement in Glasgow Coma Scale score than group A（t=3.40,P〈0.05）;group D had a significantly more improvement than group C（t=2.51,P〈0.05）.Moreover,group B had significantly lower leukocyte count（t=3.21,P〈0.05）,C-reactive protein（t=3.01,P〈0.05）,and procalcitonin（t=2.31,P〈0.05）than group A;group D had significantly lower leukocyte count（t=3.42,P〈0.05）,C-reactive protein（t=3.65,P〈0.05）,and procalcitonin（t=2.46,P〈0.05）than group C.Additionally,group B had significantly lower incidence rates of gastrointestinal symptoms such as abdominal distension,diarrhea,and reflux than group A（χ^2=3.98,P〈0.05）;group D had significantly lower incidence rates than group C（χ^2=4.11,P〈0.05）.Conclusion Probiotics combined with enteral nutrition can effectively protect th

关 键 词：颅脑损伤 肠道营养 胃肠道微生物组 治疗结果 

分 类 号：R651[医药卫生—外科学] R459.9[医药卫生—临床医学]