摘要
目的探讨添加益生菌的早期肠内营养鼻饲治疗对危重病患者营养状况及肠黏膜屏障的影响。方法选取2013年1月～2018年6月住院治疗的危重病患者80例,随机分为观察组和对照组,各40例。对照组患者予留置胃管鼻饲早期肠内营养,观察组患者再加双歧杆菌三联活菌胶囊630 mg研磨水化鼻饲管注入,2次/d,连用14 d。观察并比较两组患者治疗前和治疗14 d后营养状况[血清总蛋白(TP)和白蛋白(ALB)]、肠黏膜屏障指标[血清D-乳酸及前降钙素(PCT)]及胃肠道并发症的变化。结果治疗14 d后,两组患者血清TP和ALB水平均较前明显下降(P<0.05或P<0.01),且观察组患者下降幅度明显低于对照组(P<0.05);同时两组患者血清D-乳酸及PCT水平较前均明显下降(P<0.05或P<0.01),且观察组患者下降值较对照组更明显(P<0.05);且治疗14 d期间,观察组患者胃肠道并发症发生率明显低于对照组(χ~2=4.02,P<0.05)。结论添加益生菌的早期肠内营养鼻饲治疗可减缓危重病患者营养状况恶化,下调血清D-乳酸及PCT水平,保护肠黏膜屏障,改善患者的胃肠道功能,降低胃肠道并发症的发生。
Objective To investigate the effects of early enteral nutrition with probiotics on the nutritional status and intestinal mucosal barrier in critically ill patients. Methods 80 patients with critically ill patients hospitalized from January 2013 to June 2018 were randomly divided into two groups(40 in the observation group and 40 in the control group). The patients in the control group were given indwelling gastric tube nasal feeding for early enteral nutrition. The patients in the observation group were also injected with 630 mg of bacteriological gastrointestinal feeding tube of bifidobacterium triple viable capsules twice a day for 14 days. The nutritional status of the two groups of patients [serum total protein(TP)and albumin(ALB)], intestinal mucosal barrier index [serum D-lactic acid and procalcitonin(PCT)] and gastrointestinal tract complications changes before and after 14 days of treatment were observed and compared. Results After 14 days of treatment, the serum levels of TP and ALB were significantly lower in the two groups compared with those before treatment(P<0.05 or P<0.01), and the descend range in the observation group was significantly lower than that in the control group(P<0.05). Serum D-lactic acid and PCT levels in the two groups were significantly lower than before(P<0.05 or P<0.01), and the decreased value in the observation group was more significant than that in the control group(P<0.05). During the 14-day treatment period, the incidence of the gastrointestinal tract complications of the observation group was significantly lower than that of the control group(χ^2=4.02, P<0.05). Conclusion Early enteral nutrition with probiotics can slow the deterioration of nutritional status in critically ill patients, down-regulate serum D-lactic acid and PCT levels, protect intestinal mucosal barrier, improve gastrointestinal function and reduce gastrointestinal complications.
作者
王永卫
陈卫挺
WANG Yongwei;CHEN Weiting(Emergency and Critical Care Medicine Center,Wenling Traditional Chinese Medicine Medical Center(Group)Taizhou Hospital of Integrated Traditional and Western Medicine,Taizhou 317523,China)
出处
《中国现代医生》
2019年第8期80-83,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2018KY919)
关键词
危重病
益生菌
早期肠内营养
营养状况
肠黏膜屏障
Critical illness
Probiotics
Early enteral nutrition
Nutritional status
Intestinal mucosal barrier
