早期肠内营养对颅脑损伤患者肠道免疫功能及感染的影响  

Effects of Early Enteral Nutrition on Intestinal Immune Function and Infection in Patients with Craniocerebral Injury

作　　者：佘建虎 徐步轩 戎聪学 SHE Jian-hu;XU Bu-xuan;RONG Cong-xue(Zhangye Third General Hospital,Zhangye,Gansu,734000,China)

机构地区：[1]张掖市第二人民医院

出　　处：《中国初级卫生保健》2019年第11期123-125,共3页Chinese Primary Health Care

摘　　要：目的探讨早期肠内营养对颅脑损伤患者肠道免疫功能及感染的影响。方法选取2014年6月—2017年10月张掖市第二人民医院神经外科重症监护病房收治的颅脑损伤患者80例,随机分为研究组和对照组,每组各40例。对照组采用肠外和肠内营养支持序贯的方法,研究组采用早期肠内营养支持。各组患者均于肠内营养开始第1天、7天和15天,Elisa法检测外周血中IL-6、IL-10、IL-17、IgA、IgG、内毒素(ET)和降钙素原(PCT)水平等。血常规仪检测外周血白细胞计数、淋巴细胞计数。记录各组患者治疗期间医院感染情况。结果研究组营养第15天,血清IL-6、IL-10和IL-17水平有降低趋势且明显低于对照组,差异有统计学意义(P<0.01)。研究组营养第7天、第15天血清IgA、IgG水平均明显高于对照组,差异有统计学意义(P<0.01)。研究组营养第7天、第15天,血清ET、CRP和PCT水平均明显低于对照组,差异有统计学意义(P<0.01)。研究组营养第15天血白细胞计数明显低于对照组,第7天、第15天血淋巴细胞计数均明显高于对照组,差异有统计学意义(P<0.01)。结论早期肠内营养方式有利于恢复机体免疫功能,显著降低炎症反应和感染发生率,缩短了住院时间,对重型颅脑损伤患者的治疗和预后具有重要意义。OBJECTIVE To explore the effects of early enteral nutrition on intestinal immune function and infection in patients with cranio cerebral injury.METHODS From June 2014 to October 2017,80 patients with craniocerebral injury admitted to the department of neuro surgical intensive care in TARGET hospital were randomly divided into the study group and the control group,with 40 cases in each group.The control group adopted the method of parenteral and enteral nutrition support,and the study group adopted early enteral nutri tion support.Each patient was started in enteral nutrition 1,7,15 days,Elisa method to detect peripheral blood of IL-6,IL-10,IL-17,IgA,IgG,endotoxin(ET),calcitonin(PCT)level.The blood cell count and lymphocyte count were detected by blood routine.To record the hospital infection during treatment of each group.Statistical ventilator use time,hospital stay,30 days mortality.RESULTS The serum IL-6,IL-10 and IL-17 were significantly lower in study group than the control group,and the difference was statistically sig nificant(P<0.01).In the 7th day of nutrition,serum IgA and IgG levels were significantly higher than those in the control group.The dif ference was statistically significant(P<0.01).In the 7th day of the study,serum ET,CRP and PCT were significantly lower than those in the control group,with statistically significant difference(P<0.01).The blood cell count was significantly lower than the control group in the 15th day of nutrition of the study group,and the blood lymphocyte count in the 7th and 15th day was significantly higher than that in the control group,and the difference was statistically significant(P<0.01).The lung infection rate of the study group was significantly lower than the control group,and the duration of use of ventilator and the length of hospital stay were significantly shorter than that in the control group,and the difference was statistically significant(P<0.01).CONCLUSION Early enteral nutrition was beneficial to restore the body’s immune function,significantly reduce

关 键 词：肠内营养 颅脑损伤 免疫功能 感染 

分 类 号：R651.1[医药卫生—外科学]