谷氨酰胺联合复合益生菌粉强化早期肠内营养对脑梗死患者营养状况及消化道耐受性效果研究  

Effect of glutamine combined with compound probiotic powder to strengthe early enteral nutrition on nutritional status and gastrointestinal tolerance in patients with cerebral infarction

作　　者：张露艺[1] 江涛[1] 李金燕[1] 黄秋宇 文秀玉[1] 龙晓静[1] ZHANG Luyi;JIANG Tao;LI Jinyan;HUANG Qiuyu;WEN Xiuyu;LONG Xiaojing(Department of Nutrition,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi 530000,China)

机构地区：[1]广西中医药大学第一附属医院营养科,广西南宁530000

出　　处：《现代医药卫生》2024年第22期3791-3793,3799,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金项目(82360020);广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20211340)。

摘　　要：目的观察谷氨酰胺联合复合益生菌粉强化早期肠内营养对脑梗死患者营养状况及胃肠功能的影响。方法选取2021年7月至2023年12月该院收治的需肠内营养支持的脑梗死患者60例,采用随机数字表法分为研究组和对照组,每组30例。入院24~48 h内开始给予肠内营养支持。对照组鼻饲整蛋白肠内营养液,浓度1 kcal/mL,能量25 kcal/(kg·d),总液量均分为4餐进行鼻饲。研究组在鼻饲整蛋白肠内营养液基础上添加谷氨酰胺每次2.5 g、复合益生菌粉每次1 g。记录2组患者有无消化道症状,10 d后检测前清蛋白、清蛋白、血红蛋白等变化情况。结果2组患者营养支持前前清蛋白、清蛋白、血红蛋白水平比较,差异均无统计学意义(P>0.05)。2组患者肠内营养支持第10天前清蛋白水平比较,差异无统计学意义(P>0.05)。研究组患者肠内营养支持第10天清蛋白、血红蛋白水平均明显高于对照组,出现消化道症状概率明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者中出现消化道症状16例(53.3%),其中腹泻8例,出血4例,便秘4例;对照组患者中出现消化道症状24例(80.0%),其中出血11例,腹泻7例,呕吐3例,便秘2例,胃潴留1例。2组消化道症状发生率比较,差异有统计学意义(χ^(2)=4.800,P<0.05)结论在早期肠内营养中强化谷氨酰胺和复合益生菌粉能减缓患者营养指标下降、降低胃肠道症状出现概率。Objective To observe the effect of glutamine combined with compound probiotics powder to enhance early enteral nutrition on nutritional status and gastrointestinal function in patients with cerebral infarction.Methods A total of 60 patients with cerebral infarction who needed enteral nutrition support in the hospital from July 2021 to December 2023 were selected and divided into the study group and the control group by random number table method,with 30 patients in each group.Enteral nutritional support was given within 24-48 hours after admission.The control group was nasally fed enteral nutrient solution of whole protein with concentration of 1 kcal/mL and an energy of 25 kcal/(kg·d),and the total fluid volume was divided into four meals for tube feeding.On the basis of nasal feeding whole protein enteral nutrition solution,the study group added glutamine 2.5 g each time and compound probiotics powder 1 g each time.The gastrointestinal symptoms of the two groups were recorded,and the changes of prealbumin,albumin and hemoglobin were detected after 10 days.Results There was no significant differences in prealbumin,albumin and hemoglobin levels between the two groups before nutritional support(P>0.05).There was no significant difference in albumin level between the two groups before the 10th day of enteral nutrition support(P>0.05).The levels of albumin and hemoglobin on the 10th day of enteral nutrition support in the study group were significantly higher than those in the control group,and the probability of gastrointestinal symptoms was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).In the study group,16 cases(53.3%)had gastrointestinal symptoms,including eight cases of diarrhea,four cases of bleeding and four cases of constipation.In the control group,24 cases(80.0%)had gastrointestinal symptoms,including 11 cases of bleeding,seven cases of diarrhea,three cases of vomiting,two cases of constipation,and one case of retention.There was a statistica

关 键 词：谷氨酰胺 益生菌 益生元 脑梗死 早期肠内营养 

分 类 号：R743.33[医药卫生—神经病学与精神病学]