摘要
目的探讨在脑出血术后患者中早期应用含膳食纤维肠内营养,对其免疫功能和预后的影响.方法选择的研究对象为在2012-02/2017-02期间,天津市宁河区医院收治的行脑出血手术后的120例患者,根据手术后营养支持方案的不同分为给予含膳食纤维肠内营养支持的观察组,和给予普通肠内营养支持的对照组,每组均60例患者.然后将两组患者的免疫球蛋白、淋巴细胞数目、细胞因子CD4+、细胞因子CD8+、CD4+/CD8+比值等免疫指标、术后并发症情况及6 mo后GOS评分等指标进行比较.结果在手术次日,两组患者在免疫球蛋白G(immunoglobulin G,Ig G)、Ig A、Ig M、免疫细胞数目、CD4+、C D8+、CD4+/C D8+比值等免疫指标上无明显差异,不具有统计学意义(P>0.05);在手术后2 wk,观察组患者的Ig G、Ig A、Ig M、免疫细胞数目、CD4+、C D4+/C D8+比值明显高于对照组(17.19±3.31 vs11.82±1.91、2.83±0.76 vs 1.89±0.63、4.08±0.56vs 2.52±0.58、2.83±0.53 vs 1.29±0.29、47.56±10.36 vs 32.09±8.21、1.65±0.41 vs 1.09±0.06),差异具有统计学意义(P<0.05);观察组患者的CD8+明显低于对照组(26.03±5.98 vs 29.31±5.21),差异具有统计学意义(P<0.05);对照组患者住院期间的不良反应发生率显著高于观察组(66.67%vs 43.33%),差异具有统计学意义(P<0.05);在手术后6 mo,观察组患者的GOS评分显著高于对照组(4.09±0.31 vs 3.11±0.23),差异有统计学意义(P<0.05).结论在脑出血术后患者中早期应用含膳食纤维的肠内营养治疗方案,能够显著改善患者的免疫状态,减少住院期间并发症发生率,改善患者预后.
AIM To investigate the effect of early dietary fiber-containing enteral nutrition on the immune function and prognosis of patients with cerebral hemorrhage.METHODS One hundred and twenty patients who underwent surgery for cerebral hemorrhage at our hospital from February 2012 to February 2017 were randomly and equally divided into an observation group, which was given early dietary fiber-containing enteral nutrition, and a control group, which was given conventional enteral nutrition support. Immunoglobulins, lymphocyte count, percentage of CD4＋ T cells, percentage of CD8＋ T cells, CD4＋/CD8＋ ratio, postoperative complications, and Glasgow Outcome Scale（GOS） score at 6 months were compared between the two groups. RESULTS On the day after surgery, there was no significant difference in Ig G, Ig A, Ig M, lymphocyte count, percentage of CD4＋ T cells, percentage of CD8＋ T cells, or CD4＋/CD8＋ ratio between the two groups（P〈0.05）. Two weeks after operation, IgG, IgA, IgM, lymphocyte count, percentage of CD4＋ T cells, and CD4＋/CD8＋ were significantly higher in the observation group than in the control group（17.19 ± 3.31 vs 11.82 ± 1.91, 2.83 ± 0.76 vs 1.89 ± 0.63, 4.08 ± 0.56 vs 2.52 ± 0.58, 2.83 ± 0.53 vs 1.29 ± 0.29, 47.56 ± 10.36 vs 32.09 ± 8.21, 1.65 ± 0.41 vs 1.09 ± 0.06, P〈0.05）, while the percentage of CD8＋ T cells in the observation group was significantly lower than that in the control group（26.03 ± 5.98 vs 29.31 ± 5.21, P〈0.05）. During hospitalization, the incidence of adverse reactions was significantly higher in the control group than in the observation group（66.67% vs 43.33%, P〈0.05）. Six months after operation, the GOS score was significantly higher in the observation group than in the control group（4.09 ± 0.31 vs 3.11 ± 0.23, P〈0.05）.CONCLUSION Early dietary fiber-containing enteral nutrition inpatients with cerebral hemorrhage can significantly improve the immune status of patients, reduce the incidence of complications during hospitalization, and improve the prognosis of patients.
出处
《世界华人消化杂志》
CAS
2017年第36期3235-3240,共6页
World Chinese Journal of Digestology
关键词
脑出血
术后
肠内营养
膳食纤维
免疫功能
Cerebral hemorrhage
Postoperative
Enteralnutrition
Dietary fiber
Immune function
