颅脑损伤重症患者肠内营养期给予四联杆菌与GOS预防腹泻的效果观察  

Observation of Tetrabacterium and Galactooligosaccharides on preventing diarrhea in patients with severe craniocerebral injury during enteral nutrition

作　　者：赵丽坤[1] 左志刚[1] 李开双 张梅香 裴柳 ZHAO Likun;ZUO Zhigang;LI Kaishuang(District 1,Department of Critical Care Medicine,First Hospital of Qinhuangdao,Hebei,Qinhuangdao 066000,China)

机构地区：[1]河北秦皇岛市第一医院重症医学科一区,066000 [2]河北秦皇岛市第一医院检验科,066000

出　　处：《河北医药》2023年第4期541-543,547,共4页Hebei Medical Journal

基　　金：河北省秦皇岛市重点研发计划科技支撑项目(编号:202004A118)。

摘　　要：目的 探讨颅脑损伤重症患者肠内营养期间给予四联杆菌与低聚半乳糖(GOS)预防腹泻的效果。方法 选取2019年3月至2021年7月收治的重度颅脑损伤患者78例,随机分成对照组与研究组,每组39例,均予以肠内营养支持,研究组加用四联杆菌、GOS,观察2组腹泻症状、营养状况、炎症指标及神经功能恢复情况。结果 研究组腹泻发生率17.95%较对照组38.46%明显下降,且研究组水样便发生率5.13%明显低于对照组23.08%,差异均有统计学意义(P<0.05);相较于对照组,研究组腹泻次数减少,腹泻开始时间明显延后,腹泻持续时间明显缩短,差异有统计学意义(P<0.05);治疗7 d、14 d 2组GCS评分均较治疗前升高(P<0.05),组间比较,研究组治疗7 d、治疗14 d的GCS评分均明显高于对照组,差异有统计学意义(P<0.05);治疗后研究组TP、ALB、Hb高于对照组,而CRP、PCT低于对照组,差异有统计学意义(P<0.05)。结论 颅脑损伤重症患者肠内营养期间给予四联杆菌与GOS可有效预防和减轻腹泻症状,缩短腹泻病程,改善患者营养状况,减轻炎症反应,并有助促进患者神经功能恢复。Objective To investigate the effect of Tetrabacterium and Galactooligosaccharide(GOS)on preventing diarrhea during enteral nutrition in patients with severe craniocerebral injury.Methods A total of 78 patients with severe craniocerebral injury admitted to our hospital from March 2019 to July 2021 were randomly assigned into control group and study group,with 39 cases in each group.All of them were given to enteral nutrition support,and patients in the study group were additionally administrated with Tetrabacterium and GOS.Diarrhea,nutritional status,inflammation indicators and neurological function recovery in the two groups were compared.Results Compared with those of control group,the incidence of diarrhea(38.46%vs 17.95%)and watery stool(23.08%vs 5.13%)in the study group was significantly lower(P<0.05).Compared with the control group,patients in the study group had significantly fewer diarrhea,delayed onset of diarrhea,and shortenedduration of diarrhea(all P<0.05).Glasgow Coma Scale(GCS)scores inthe two groups on 7d and 14d of treatment were significantly higher than those before treatment,which were significantly higher in the study group than those of control group(P<0.05).After treatment,total protein(TP),albumin(ALB),and hemoglobin(Hb)in the study group were significantly higher than those in the control group,while C reactive protein(CRP)and procalcitonin(PCT)were significantly lower than those in the control group(P<0.05).Conclusion Enteral nutrition of Tetrabacterium combined with GOS can effectively prevent and reduce the symptoms of diarrhea,shorten the course of diarrhea,improve the nutritional status,reduce inflammation,and promote the recovery of nerve function in patients with severe craniocerebral injury.

关 键 词：重症颅脑损伤 肠内营养 四联杆菌 低聚半乳糖 腹泻 营养状况 

分 类 号：R651.15[医药卫生—外科学]