膳食纤维饮食对颅脑损伤早期肠内营养病人胃肠道功能障碍的影响  

Effect of the dietary fiber diet on gastrointestinal dysfunction in patients with early enteral nutrition after craniocerebral injury

作　　者：周小梅 曹芹[1] 江芹 孙文杰 乔丹 孙静[1] 房梦甜 王久强 张夏婉 杨从艳[1] ZHOU Xiao-mei;CAO Qin;JIANG Qin;SUN Wen-jie;QIAO Dan;SUN Jing;FANG Meng-tian;WANG Jiu-qiang;ZHANG Xia-wan;YANG Cong-yan(School of Neurosurgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;School of Nursing,Bengbu Medical College,Bengbu Anhui 233030,China)

机构地区：[1]蚌埠医学院第一附属医院神经外科,安徽蚌埠233004 [2]蚌埠医学院护理学院,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2023年第12期1766-1770,共5页Journal of Bengbu Medical College

摘　　要：目的:探讨膳食纤维(DF)饮食对颅脑损伤早期肠内营养病人胃肠道功能障碍的作用。方法:选取实施肠内营养的90例颅脑损伤病人,按照入院时间先后顺序分为对照组30例(A组),观察组各30例(B组和C组)。A组给予肠内营养混悬液;观察B组给予肠内营养混悬液+低DF;观察C组给予肠内营养混悬液+高DF,进行7 d的DF饮食干预,观察3组病人腹泻、便秘、呕吐/反流、消化道出血的发生情况。记录入院第1天、第4天、第7天的C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原值(PCT);记录入组病人干预前后GCS评分数值。结果:3组病人胃肠道功能障碍的发生率比较差异有统计学意义(P<0.01),C组肠道功能障碍的发生率低于A组(P<0.05),B组和C组发生率比较差异无统计学意义(P>0.05)。C组腹泻发生率低于A组(P<0.05);3组病人在第1天机体炎症指标比较差异无统计学意义(P>0.05);在第4天,A组CRP高于B组和C组,A组、B组WBC和PCT高于C组,差异有统计学意义(P<0.01);在第7天,A组、B组CRP高于C组,A组WBC高于B组和C组,A组PCT高于C组,差异有统计学意义(P<0.01);A组病人干预后GCS评分7~9分比例低于C组(P<0.05)。结论:DF饮食能够降低早期肠内营养病人胃肠道功能障碍的发生率,且高DF饮食比低DF饮食效果更好,能减轻颅脑损伤病人炎症反应,但对意识状态的变化在短期内没有影响。Objective To investigate the effects of dietary fiber(DF)diet on gastrointestinal dysfunction in patients with early enteral nutrition after craniocerebral injury.Methods A total of 90 patients with traumatic brain injury were divided into the control group(group A)and observation group(group B and group C)according to the order of admission time(30 cases in each group).Group A was treated with the enteral nutrition suspension.The group B was treated with the enteral nutrition suspension combined with low DF,and the group C was treated with the enteral nutrition suspension combined with high DF for 7 days.The incidence rates of diarrhea,constipation,vomiting/reflux and gastrointestinal bleeding were observed in the three groups.The C-reactive protein(CRP),white blood cell count(WBC)and procalcitonin(PCT)were recorded on the first,fourth and seventh day of admission.The GCS scores of three groups were recorded before and after intervention.Results The differences of the incidence rates of gastrointestinal dysfunction among the three groups were statistically significant(P<0.01).The incidence rate of intestinal dysfunction in group C was lower than that in group A(P<0.05),but there was no statistical significance between group B and group C(P>0.05).The incidence rate of diarrhea in group C was lower than that in group A(P<0.05).There was no statistical significance in inflammatory indexes among the three groups on the first day(P>0.05).On the fourth day,the level of CRP in group A was higher than that in group B and group C,and the levels of WBC and PCT in group A and group B were higher than those in group C(P<0.01).On the seventh day,the levels of CRP in group A and group B were higher than that in group C,the WBC level in group A was higher than that in group B and group C,and the PCT level in group A was higher than that in group C(P<0.01).After intervention,the proportion of GCS score with 7-9 points in group A was lower than that in group C(P<0.05).Conclusions DF diet can reduce the incidence rate of gastroin

关 键 词：胃肠道功能障碍 膳食纤维 肠内营养 

分 类 号：R473[医药卫生—护理学]