摘要
目的探讨不同肠内营养支持对创伤危重患者营养及免疫功能的影响。方法选取2014年1月—2016年1月该院收治的82例创伤危重患者作为研究对象,随机分为对照组、观察组。两组患者均给予肠内营养,观察组在对照组的基础上,补充谷氨酰胺。2周后比较2组患者的营养指标:血清白蛋白(ALB)、血清总蛋白(TP)、前白蛋白(PA)及血红蛋白(Hb)等。免疫指标:在肠内营养第1天及肠内营养14 d抽取外周静脉血。细胞免疫指标:CD3+、CD4+、CD8+、IgA、IgM、IgG、C3、C4。结果观察组、对照组在干预后,营养方面:观察组、对照组治疗后ALB、TP、PA、Hb 4个指标均提高(P<0.01),观察组治疗后分别为(34.4±0.22)g/L、(61.12±1.33)g/L、(162.37±11.19)mg/L、(100.53±1.08)g/L,上升更明显(t=2.001、6.712、3.290、12.462,P<0.01)。免疫功能方面:观察组、对照组干预后C D4+、CD8+、CD4+/CD8+均改善(P<0.01),观察组改善至(48.26±5.73)%、(24.6±2.9)%、(1.99±0.89)%,改善更明显(t=2.301、3.712、3.090,P<0.01)。IgM、IgA干预后均下降,观察组下降至(1.12±033)g/L、(2.37±1.19)g/L,下降更明显(t=3.321、4.002,P<0.01)。IgG干预后均上升,观察组上升至(14.4±4.22)g/L,上升更明显(t=3.002,P<0.01)。结论补充谷氨酰胺利于创伤危重患者的营养,提高患者的免疫功能,值得推广。
Objective To study the effect of f different enteral nutritional support on the nutrition and immune function of patients with critical wound. Methods 82 eases of patients with critical wound admitted and treated in our hospital from January 2014 to January 2016 were selected and randomly divided into two groups, both groups used the enteral nutritional support, and the observation group supplemented the glutamine on the basis of the control group, and the nu- trition indexes such as ALB, TP, PA, Hb were compared between the two groups after two weeks, in terms of immune indexes： the peripheral venous blood was extracted on the first day and 14 d after the enteral nutrition; in terms of cell immune indexes： CD3±, CD4±, CD8±, IgA, IgM, IgG, C3, C4. Results After intervention, the ALB, TP, PA, Hb in- creased in the two groups（P〈0.01）, after treatment, the ALB, TP, PA, Hb were respectively （34.4±0.22）g/L, （61.12± 1.33）g/L, （162.37±11.19）rag/L, （100.53±1.08）g/L, and the increase was more obvious （t=2.001, 6.712, 3.290, 12.462, P〈0.01）, in terms of immune function： after intervention, the CD4±,CD8±,CD4±/CD8± inproved in the two groups, and the indexes inproved to （48.26±5.73）%, （24.6±2.9）%, （1.99±0.89）%in the observation group, and the inprove was more obvious （t=2.301, 3.712, 3.090, P〈0.01）, after intervention, the IgM,IgA decreased, and the indexes in the obser- vation group decreased to （1.12±033）g/L,（2.37±1.19）g/L, and the decrease was more obvious （t= 3.321, 4.002, P〈 0.01）, and the IgG increased after intervention, and the index increased to （14.4±4.22）g/L in the observation group, and the increase was more obvious （t= 3.002, P〈0.01）. Conclusion The supplement of glutamine is conductive to the nutrition of critically wound patients and improves the immune function, and it is worth promotion.
作者
李本通
LI Be n-tong(ICU,Nanjing Tongren Hospital Affiliated to Southeast University Medical School,Nanjing,Jiangsu Province,211102 China)
出处
《系统医学》
2018年第18期22-24,共3页
Systems Medicine
关键词
肠内营养支持
创伤危重患者
营养
免疫功能
Enteral nutritional support
Critically ill patients
Nutrition
Immune function
