早期不同能量比例肠内外营养支持对重型颅脑损伤病人营养指标和免疫功能的影响  

Effects of early enteral nutrition with different energy ratios on nutritional indices and immune function in patients with severe brain injury

作　　者：余小琴 王科[1] 何琦 陈英[1] YU Xiaoqin;WANG Ke;HE Qi;CHEN Ying(Department of Neurosurgery,Chongqing Emergency Medical Center,Chongqing Fourth People's Hospital,Central Hospital affiliated to Chongqing University,Chongqing 400014,China)

机构地区：[1]重庆市急救医疗中心(重庆市第四人民医院、重庆大学附属中心医院)神经外科,400014

出　　处：《临床外科杂志》2023年第9期822-825,共4页Journal of Clinical Surgery

基　　金：重庆市科卫联合医学科研项目(2020FYYX155)。

摘　　要：目的探讨早期不同能量比例肠内外营养支持对重型颅脑损伤病人营养指标和免疫功能的影响。方法2018年11月~2021年11月收治的重型颅脑损伤病人71例,用随机数字表法进行随机分组,分为低能量组(36例)和高能量组(35例)。对比两组营养指标血红蛋白(Hb)、总蛋白(PA)、血清白蛋白(Alb)、转铁蛋白(TF)、免疫指标[(免疫球蛋白A(IgA)、免疫球蛋白M(IgG)、免疫球蛋白M(IgM)、T细胞淋巴亚群CD3+、CD4+、CD8+及CD4+/CD8+)]、感染情况及预后情况。结果治疗后,低能量组营养指标Hb、TF、Alb及PA水平均高于高能量组,差异有统计学意义(P<0.05);低能量组IgA、IgG、IgM、CD3+、CD4+、CD8+及CD4+/CD8+均高于高能量组,差异有统计学意义(P<0.05);低能量组总感染率低于高能量组(5.56%vs 25.71%),差异有统计学意义(P<0.05);低能量组预后良好率高于高能量组(83.33%vs 60.00%)差异有统计学意义(P<0.05)。结论相较于早期高能量肠内外营养支持,早期低能量肠内外营养支持可改善病人营养状况和免疫功能,降低感染率。Objective To investigate the effects of early enteral nutrition support with different energy ratios on nutritional indices and immune function in patients with severe brain injury.Methods 71 patients with severe craniocerebral injury admitted to our hospital from November 2018 to November 2021 were selected as the research objects.According to the different energy of enteral and intralteral nutrient solution,they were divided into low energy group(n=36)and high energy group(n=35).Patients in the low energy group received early 50%low energy enteral and intralteral nutrition support.Patients in the high energy group received early 100%high energy parenteral nutrition support.Nutritional indexes hemoglobin(Hb),total protein(PA),serum albumin(Alb),transferrin(TF),immune indexes[(immunoglobulin A(IgA),immunoglobulin M(IgG),immunoglobulin M(IgM),T lymphocyte subsets CD3+,CD4+,CD8+and CD4+/CD8+)]were compared between the two groups.,infection and prognosis.Results After treatment,the levels of Hb,TF,Alb and PA in the low energy group were higher than those in the high energy group(P<0.05).IgA,IgG,IgM,CD3+,CD4+,CD8+and CD4+/CD8+in low energy group were higher than those in high energy group(P<0.05).The total infection rate in low energy group was lower than that in high energy group(5.56%vs 25.71%)(P<0.05).The good prognosis rate of low energy group was higher than that of high energy group(83.33%vs 60.00%)(P<0.05).Conclusion Compared with early high-energy parenteral nutrition support,early low-energy parenteral nutrition support has a more significant effect on patients with severe intracranial brain injury,which can significantly improve the nutritional status and immune function of patients,reduce infection rates.

关 键 词：不同能量比例 肠内外营养支持 重型颅脑损伤 营养指标 免疫功能 

分 类 号：R651.15[医药卫生—外科学]