摘要
目的探讨布拉氏酵母菌联合肠内营养支持治疗对重症脑卒中患者营养状况及细胞免疫功能的影响。方法选取住院治疗的重症脑卒中患者76例,随机分为联合组和对照组各38例。两组患者常规予以吸氧,保持呼吸道通畅,控制颅内压、血压及血糖,营养脑细胞,抗感染和保持酸碱平衡等治疗。对照组患者早期留置胃管鼻饲肠内营养支持治疗,肠内营养混悬液以50~100 m L/h的滴速持续滴注逐日加量至2000~2500 m L/d。联合组患者在对照组基础上加用布拉氏酵母菌0.5 g研磨水化后自胃管鼻饲注入,3次/d,连用2周。记录两组患者的治疗前后营养状况指标及细胞免疫功能的变化。结果治疗2周后,两组患者血清白蛋白、血红蛋白和上臂三头肌肌围（MAMC）水平均较前不同程度的下降（P〈0.05或P〈0.01）,且联合组下降幅度低于对照组（P〈0.05）;同时两组患者血清CD4^＋细胞水平和CD4^＋/CD8^＋比值较前明显上升（P〈0.05或P〈0.01）,且联合组上升幅度较对照组更明显（P〈0.05）,而两组治疗前后CD8^＋细胞水平比较无明显变化（P〉0.05）。结论布拉氏酵母菌联合肠内营养支持治疗重症脑卒中患者疗效明显优于单纯的肠内营养支持治疗,能减缓患者营养状况恶化,增强其细胞免疫功能。
Objective To discuss the influence of Saccharomyces boulardii combined with enteral nutrition support on nutrition state and cellular immune function of patients with severe stroke. Methods 76 cases of patients with severe stroke,who were in hospital,were selected and divided into combined group and control group at random,with 38 cases of patients in either group. The patients in two groups were given medical treatment,such like oxygen uptake,maintenance of airway patency,blood pressure and blood sugar,nutrition of brain cells,anti-infection,maintenance of acid-base balance and etc. The patients in control group were given early gastric tube indwelling nasogastric enteral nutrition support treatment and etc,and the enteral nutritional suspension（ SP） was dripped at the speed of 50-100 m L / h,which was added to 2000-2500 m L / d gradually,while the patients in combined group were additionally given 0. 5 g Saccharomyces boulardii,which were ground,hydrated and injected through nasal feeding by stomach tube,three times a day for 2 weeks. The changes of nutrition state index and immune function of patients in two groups before and after medical treatment were recorded. Results After 2 weeks＇ medical treatment,the serum albumin（ ALB）,hemoglobin（ Hb） and Mid arm muscle circumference（ AMC） levels of patients in two groups obviously declined than before（ P〈0. 05 or P〈0. 01）,and the declining rate of patients in combined group was lower than that in control group（ P〈0. 05）. Meanwhile,serum CD4^＋levels and CD4^＋/ CD8^＋ratios of patients in two groups obviously rose than before（ P〈0. 05 or P〈0. 01）,and the rising rate of patients in combined group was much higher than that in control group（ P〈0. 05）,while CD8^＋levels of patients in two groups before and after medical treatment appeared no obvious changes after comparison. Conclusion Compared pure enteral nutrition support treatment,Saccharomyces Boulardii combined with enteral nutrition support has more favorable curative effect patients with severe stroke,which can less influenced nutrition status of patients and enhance cellular immune function.
出处
《中国微生态学杂志》
CAS
CSCD
2015年第7期805-808,共4页
Chinese Journal of Microecology
关键词
重症脑卒中
布拉酵母菌
早期肠内营养
营养状况
细胞免疫
Severe stroke
Saccharomyces boulardii
Early enteral nutrition
Nutritional status
Cellular immune
