中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2013年
1期
13-16
,共4页
高血压脑出血%肠内营养%合生元%肠道菌群%分泌型IgA%感染性并发症
高血壓腦齣血%腸內營養%閤生元%腸道菌群%分泌型IgA%感染性併髮癥
고혈압뇌출혈%장내영양%합생원%장도균군%분비형IgA%감염성병발증
Hypertensive intracerebral hemorrhage%Enteral nutrition%Synbiotics%Intestinal flora%SIgA%Infectious complications
目的 观察添加合生元的早期肠内营养对高血压脑出血术后患者肠道主要正常菌群、粪便分泌型IgA (SIgA)和感染性并发症的影响.方法 将53例高血压脑出血术后患者随机分为早期肠内营养组(对照组,n =26)和添加合生元的早期肠内营养组(研究组,n=27),对照组于术后24～48 h采用肠内营养制剂(瑞素)开始营养支持；研究组在对照组的基础上,在肠内营养支持前14 d添加合生元制剂(金双歧).在营养支持前和第4、8、15天分别采集粪便标本,进行肠道主要正常菌群定量分析,采用酶联免疫吸附法测定粪便SIgA.比较研究期间两组患者感染性并发症的差异.结果 在肠内营养支持第8天和第15天,研究组大肠杆菌(P =0.004,P=0.004)和肠球菌(P=0.032,P=0.048)低于对照组,双歧杆菌(P=0.046,P=0.024)高于对照组；研究期间乳酸杆菌、类杆菌和梭菌组间比较差异均无统计学意义(P均＞0.05).在肠内营养支持第15天,研究组粪便SIgA高于对照组(P=0.035).研究组感染率低于对照组(33.33％与46.15％),但差异无统计学意义(P =0.230).结论 与普通早期肠内营养相比,添加合生元的早期肠内营养有利于促进高血压脑出血术后患者肠道菌群失衡的改善,上调肠道局部免疫功能.
目的 觀察添加閤生元的早期腸內營養對高血壓腦齣血術後患者腸道主要正常菌群、糞便分泌型IgA (SIgA)和感染性併髮癥的影響.方法 將53例高血壓腦齣血術後患者隨機分為早期腸內營養組(對照組,n =26)和添加閤生元的早期腸內營養組(研究組,n=27),對照組于術後24～48 h採用腸內營養製劑(瑞素)開始營養支持；研究組在對照組的基礎上,在腸內營養支持前14 d添加閤生元製劑(金雙歧).在營養支持前和第4、8、15天分彆採集糞便標本,進行腸道主要正常菌群定量分析,採用酶聯免疫吸附法測定糞便SIgA.比較研究期間兩組患者感染性併髮癥的差異.結果 在腸內營養支持第8天和第15天,研究組大腸桿菌(P =0.004,P=0.004)和腸毬菌(P=0.032,P=0.048)低于對照組,雙歧桿菌(P=0.046,P=0.024)高于對照組；研究期間乳痠桿菌、類桿菌和梭菌組間比較差異均無統計學意義(P均＞0.05).在腸內營養支持第15天,研究組糞便SIgA高于對照組(P=0.035).研究組感染率低于對照組(33.33％與46.15％),但差異無統計學意義(P =0.230).結論 與普通早期腸內營養相比,添加閤生元的早期腸內營養有利于促進高血壓腦齣血術後患者腸道菌群失衡的改善,上調腸道跼部免疫功能.
목적 관찰첨가합생원적조기장내영양대고혈압뇌출혈술후환자장도주요정상균군、분편분비형IgA (SIgA)화감염성병발증적영향.방법 장53례고혈압뇌출혈술후환자수궤분위조기장내영양조(대조조,n =26)화첨가합생원적조기장내영양조(연구조,n=27),대조조우술후24～48 h채용장내영양제제(서소)개시영양지지；연구조재대조조적기출상,재장내영양지지전14 d첨가합생원제제(금쌍기).재영양지지전화제4、8、15천분별채집분편표본,진행장도주요정상균군정량분석,채용매련면역흡부법측정분편SIgA.비교연구기간량조환자감염성병발증적차이.결과 재장내영양지지제8천화제15천,연구조대장간균(P =0.004,P=0.004)화장구균(P=0.032,P=0.048)저우대조조,쌍기간균(P=0.046,P=0.024)고우대조조；연구기간유산간균、류간균화사균조간비교차이균무통계학의의(P균＞0.05).재장내영양지지제15천,연구조분편SIgA고우대조조(P=0.035).연구조감염솔저우대조조(33.33％여46.15％),단차이무통계학의의(P =0.230).결론 여보통조기장내영양상비,첨가합생원적조기장내영양유리우촉진고혈압뇌출혈술후환자장도균군실형적개선,상조장도국부면역공능.
Objective To investigate the effect of early enteral nutrition combined with synbiotics agents on normal intestinal flora,fecal SIgA and infectious complications in patients with hypertensive intracerebral hemorrhage.Methods Fifty-three patients with hypertensive intracerebral hemorrhage were randomly divided into early enteral nutrition group (control group,n =26) and early enteral nutrition combined with synbiotics group (study group,n =27).The patients in control group started receiving enteral nutrition (RuiSu) within 24 to 48 hours after injury ; Patients in study group received a enteral nutritional support which as well as control group,but added synbiotics (Golden Bifid) in the first 14 days of enteral nutritional support.Stool specimens were Collected on day 0,day 4,day 8,day 15 of enteral nutrition support for quantitative analysis of normal intestinal flora and detection of stool SIgA through enzyme-linked immunosorbent assay.The difference of two groups in infectious complications were observed.Results On nutritional support day 8 and day 15,escherichia coli (P =0.004,P =0.004) and enterococci (P =0.032,P =0.048) expression were lower in study group than the control group,bifidobacteria (P =0.046,P =0.024) expression were higher in study group than the control group.During the study period lactobacillus,bacteroides and clostridium were no statistically significant between the two groups (P ＞ 0.05).Fecal SIgA expression in study group was higher than control group (P =0.035) on nutritional support dayl5.The incidence of infectious complications in study group was lower than the control group (33.33％ vs.46.15％),but there was no significant difference (P =0.230).Conclusion compared with ordinary enteral nutrition,enteral nutrition combined with synbiotics agents can be effective in improving intestinal flora imbalance and increase intestinal immune function in patients with hypertensive intracerebral hemorrhage.
