摘要
目的观察免疫肠内营养对急性应激患者肠道耐受性、炎性因子的影响。方法选取2018年6月—2019年8月上海中医药大学附属曙光医院急诊内科收治急性应激患者112例作为研究对象,随机数字表法分为2组,每组56例。对照组予一般营养治疗,研究组在对照组基础上给予免疫肠内营养治疗,疗程均为7 d。比较治疗前后2组患者炎性因子[白细胞(WBC)、淋巴细胞(LY)与C反应蛋白(CRP)]、营养指标[血浆总蛋白(TP)、白蛋白(ALB)、前体白蛋白(PA)]、肠道大肠杆菌数的变化情况,以及患者肠道耐受性(呕吐、腹泻),治疗后感染、死亡与住院时间。结果治疗7天后,2组TP、ALB水平及WBC计数比较差异无统计学的意义(P>0.05);研究组PA和LY计数高于对照组,而CRP低于对照组(t/P=5.812/0.000、2.626/0.010、10.264/0.000);研究组大肠杆菌数明显低于对照组(t/P=8.657/0.000)。2组感染率、住院时间比较差异无统计学意义(P>0.05),而研究组患者呕吐、腹泻的发生率及病死率显著低于对照组(χ^2/P=4.667/0.031、4.940/0.026)。结论免疫肠内营养治疗可显著改善急性应激患者的营养不良状态,减轻炎性反应,增强肠道的耐受性,改善肠道菌群失调,降低病死率。
Objective To observe the effect of immune enteral nutrition on intestinal tolerance and inflammatory factors in patients with acute stress.Methods From June 2018 to August 2019,112 patients with acute stress admitted to the Department of Emergency Medicine of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were selected as the research objects.They were randomly divided into two groups,56 cases in each group.The control group was given general nutritional treatment,and the study group was given immune enteral nutrition therapy on the basis of the control group,and the course of treatment was 7 days.The changes of inflammatory factors(white blood cell(WBC),lymphocyte(LY),C-reactive protein(CRP),nutritional indicators(total plasma protein(TP),albumin(ALB),prealbumin(PA),intestinal coliform count,intestinal tolerance(vomiting,diarrhea),infection,death and hospitalization time after treatment were compared between the two groups before and after treatment.Results After 7 days treatment,there was no significant difference in the levels of TP,ALB and WBC between the two groups(P>0.05);the PA and ly counts in the study group were higher than those in the control group,while CRP was lower than that in the control group(t/P=5.812/0.000,2.626/0.010,10.264/0.000).After treatment,the number of Escherichia coli in the study group was significantly lower than that in the control group(t/P=8.657/0.000).There was no significant difference in infection rate and hospitalization time between the two groups(P>0.05),but the incidence and mortality of vomiting and diarrhea in the study group were significantly lower than those in the control group(χ^2/P=4.667/0.031,4.940/0.026).Conclusion Immunoenteral nutrition therapy can significantly improve the malnutrition state of patients with acute stress,reduce the inflammatory reaction,enhance the intestinal tolerance of patients,improve intestinal flora imbalance,and reduce mortality.
作者
欧阳洋
施荣
王庆
王文清
周丹
Ouyang Yang;Shi Rong;Wang Qing;Wang Wenqing;Zhou Dan(Department of Emergency Medicine, Shuguang Hospital Affiliated to Shanghai University of Chinese Medicine, Shanghai 200021,China)
出处
《疑难病杂志》
CAS
2020年第9期909-912,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(81774057)。
关键词
急性应激
免疫肠内营养
耐受性
炎性因子
Acute stress
Immunity
Enteral nutrition
Tolerance
Inflammatory factor
