摘要
目的:探讨超早期肠内营养治疗重度颅脑损伤对肠道功能恢复和炎症反应的影响。方法:选择2017年12月至2018年12月在我院诊治重度颅脑损伤的患者136例,根据随机数字法将患者分为观察组和对照组,每组各68例。对照组予以肠外营养治疗,观察组予以超早期肠内营养治疗。观察两组治疗后的疗效,两组治疗前后白蛋白、前白蛋白、转铁蛋白、格拉斯哥评分(GCS)、慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官功能衰竭评分(SOFA)、D-乳酸、内毒素、二胺氧化酶(DAO)、神经元特异性烯醇化酶(NSE)、白介素(IL)-6和肠型脂肪酸结合蛋白(I-FABP)水平的变化。结果:观察组的总有效率为92.65%,优于对照组的76.47%(χ^2=5.632,P<0.05)。两组治疗前的白蛋白、前白蛋白、转铁蛋白、GCS、APACHEⅡ、SOFA、D-乳酸、内毒素、DAO、NSE、IL-6和I-FABP水平差异无统计学意义(P>0.05);治疗后两组白蛋白、前白蛋白,转铁蛋白,GCS评分较治疗前升高(P<0.01),APACHEⅡ、SOFA、D-乳酸、内毒素、DAO、NSE、IL-6和I-FABP较治疗前降低(P<0.01),而观察组的升高或者降低幅度较对照组更为明显(P<0.01)。结论:超早期肠内营养治疗重度颅脑损伤能够提高疗效,具有促进机体营养恢复,修复胃肠道功能紊乱,抑制机体炎症介质释放的作用。
Objective:To investigate the impact of ultra-early enteral nutrition on intestinal function recovery and inflammatory response in patients with severe craniocerebral injury.Methods:136 patients with severe craniocerebral injury in our hospital,from December 2017 to December 2018,were divided into observation group and control group according to random number method,with 68 cases in each group.The control group was treated with parenteral nutrition,and the observation group was treated with ultra-early enteral nutrition.The efficacy was observed in two groups after treatment,and the albumin,prealbumin,transferrin,Glasgow score(GCS),chronic health status scoreⅡ(APACHEⅡ),sequential organ failure assessment score(SOFA),D-lactic acid,endotoxin,diamine oxidase(DAO),neuron-specific enolase(NSE),interleukin(IL)-6 and intestinal fatty acid binding protein(I-FABP)levels of the two groups were also compared before and after treatment.Results:The total effective rate was 92.65% in the observation group,which was better than the control group(76.47%)(χ^2=5.632,P<0.05).There was no statistical differences in the levels of albumin,prealbumin,transferrin,GCS,APACHEⅡ,SOFA,D-lactic acid,endotoxin,DAO,NSE,IL-6 and I-FABP between the two groups before treatment(P>0.05).After treatment the levels of albumin,prealbumin,transferrin and GCS in the two groups were higher than those before treatment(P<0.01),the APACHEⅡ,SOFA,D-lactic acid,endotoxin,DAO,NSE,IL-6 and I-FABP levels were lower than those before treatment(P<0.01),while the increase and decrease in the observation group were more obvious than those of the control group(P<0.01).Conclusion:Ultra-early enteral nutrition can improve the efficacy of severe craniocerebral injury,promote the recovery of body nutrition,repair gastrointestinal dysfunction,and inhibit the release of inflammatory mediators.
作者
施辉
SHI Hui(Department of Nutrition,Shanghai Yangpu District Central Hospital,Shanghai 200090,China)
出处
《中国医药导刊》
2019年第12期708-712,共5页
Chinese Journal of Medicinal Guide
关键词
超早期肠内营养
重度颅脑损伤
肠道功能紊乱
炎症反应
Ultra-early enteral nutrition
Severe craniocerebral injury
Intestinal dysfunction
Inflammatory response
