ERAS理念下行个体化肠内营养对老年颅脑损伤病人免疫功能和炎症因子水平的影响  

Effects of individualized enteral nutrition under the concept of ERAS on immune function and inflammatory cytokines in elderly patients with craniocerebral injury

作　　者：刘辉[1] 黄敏[1] 田雅丽 毕立清[3] 童孜蓉[3] 储博文 赵倩[3] LIU Hui;HUANG Min;TIAN Ya-li;BI Li-qing;TONG Zi-rong;CHU Bo-wen;ZHAO Qian(Geriatric ICU,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Critical Care Department,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属第一医院老年ICU,江苏省南京市210029 [2]南京医科大学附属第一医院危重症科,江苏省南京市210029 [3]南京医科大学附属第一医院神经外科,江苏省南京市210029

出　　处：《实用老年医学》2023年第6期573-576,共4页Practical Geriatrics

基　　金：江苏省卫生厅"兴卫工程"重点个人医学研究基金(RC201156);江苏省重点医学学科(RC201156);江苏省人民医院课题项目(YHK201758)。

摘　　要：目的探讨快速康复(ERAS)理念下行个体化肠内营养对老年颅脑损伤病人免疫功能和炎症因子水平的影响。方法将94例老年颅脑外伤病人采用随机数表法分为观察组和对照组,每组各47例。观察组入院48 h后开始给予个体化肠内营养支持治疗;对照组给予常规肠内营养治疗。治疗前、治疗14 d后分别检测2组病人的IL-6、IL-8、TNF-α等炎性因子以及T淋巴细胞亚群水平,并比较2组病人感染发生率及住院时间。结果治疗14 d后,2组病人的血清IL-6、IL-8及TNF-α水平均明显降低(P<0.05),免疫功能指标CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)均明显升高(P<0.05);且观察组病人的各项指标水平与对照组相比,差异均具有统计学意义(P<0.05或P<0.01)。观察组住院时间明显少于对照组,差异有统计学意义(P<0.05)。结论ERAS理念下个体化肠内营养可有效提高老年颅脑损伤病人的免疫功能,降低炎性因子水平,促进病人康复。Objective To investigate the effects of individualized enteral nutrition under the concept of enhanced recovery after surgery(ERAS)on immune function and inflammatory cytokines in the elderly patients with craniocerebral injury.Methods A total of 94 elderly patients with craniocerebral injury were randomly divided into the observation group and the control group,with 47 patients in each group.The observation group was given individualized enteral nutrition support 48 hours after admission,and the control group was given routine enteral nutrition treatment.The levels of inflammatory factors such as interleukin 6(IL-6),IL-8,tumor necrosis factor-α(TNF-α)and T lymphocyte subsets were measured before and 14 days after treatment.The infection rate and hospitalization time were compared between the two groups.Results After 14 days of treatment,the levels of serum IL-6,IL-8 and TNF-αin the two groups were significantly decreased(P<0.05),and the immune function indexes such as CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were significantly increased(P<0.05),especially in the observation group(P<0.05 or P<0.01).The hospitalization time of the observation group was significantly shorter than that of the control group.Conclusions Under the concept of ERAS,individualized enteral nutrition can effectively improve the immune function of the elderly patients with craniocerebral injury,reduce the levels of inflammatory factors,and promote the patients’recovery.

关 键 词：个体化肠内营养 颅脑损伤 免疫功能 炎性因子 

分 类 号：R651.15[医药卫生—外科学] R459.3[医药卫生—临床医学]