CAJ | 학술논문

目的观察早期肠内营养中添加益生菌对重型颅脑损伤患者胃肠动力障碍和营养状况的影响. 方法选取重型颅脑损伤患者40例,按随机数字表法将患者分为试验组(18例)和对照组(22例),两组患者均在入院后24～72 h内经鼻胃管开始肠内营养,试验组在肠内营养基础上添加益生菌.观察整个试验期间患者腹胀、呕吐、反流、胃潴留、便秘、腹泻的发生率,首次排便时间及达肠内营养目标量时间.检测营养开始第0,4,7,15天血清前白蛋白、转铁蛋白等营养指标,并比较住ICU时间. 结果两组患者腹胀、呕吐、胃潴留、腹泻差异均无统计学意义,试验组发生反流、便秘例数少于对照组(P＜0.05).首次排便时间及达肠内营养目标量时间提前于对照组(P＜0.05).两组前白蛋白、转铁蛋白水平在营养第0,4,7天差异均无统计学意义,在营养第15天试验组前白蛋白、转铁蛋白水平均高于对照组(P＜0.05).两组住ICU时间差异无统计学意义. 结论与单纯肠内营养比较,添加益生菌的肠内营养能改善重型颅脑损伤患者胃肠动力障碍,促进肠内营养顺利实施,从而提高机体营养状况.
목적 관찰조기장내영양중첨가익생균대중형로뇌손상환자위장동력장애화영양상황적영향. 방법 선취중형로뇌손상환자40례,안수궤수자표법장환자분위시험조(18례)화대조조(22례),량조환자균재입원후24～72 h내경비위관개시장내영양,시험조재장내영양기출상첨가익생균.관찰정개시험기간환자복창、구토、반류、위저류、편비、복사적발생솔,수차배편시간급체장내영양목표량시간.검측영양개시제0,4,7,15천혈청전백단백、전철단백등영양지표,병비교주ICU시간. 결과 량조환자복창、구토、위저류、복사차이균무통계학의의,시험조발생반류、편비례수소우대조조(P＜0.05).수차배편시간급체장내영양목표량시간제전우대조조(P＜0.05).량조전백단백、전철단백수평재영양제0,4,7천차이균무통계학의의,재영양제15천시험조전백단백、전철단백수평균고우대조조(P＜0.05).량조주ICU시간차이무통계학의의. 결론 여단순장내영양비교,첨가익생균적장내영양능개선중형로뇌손상환자위장동력장애,촉진장내영양순리실시,종이제고궤체영양상황.
Objective To investigate effect of early enteral nutrition supplemented with probiotics on gastrointestinal motility disturbance and nutritional status in patients with severe craniocerebral trauma.Methods Forty patients with severe craniocerebral trauma were randomized into study group (18patients) and control group (22 patients).Patients of both groups received enteral nutrition via nasogastric tube at 24-72 hours after admission,but the patients of study group were also supplemented with probiotics simultaneously.Rate of abdominal distention,vomiting,gastro-oesophageal reflux,gastric retention,constipation and diarrhea were recorded during the whole study.Time to first defecation and time to targeted nutritional goals were also recorded.Prealbumin and transferrin in serum were detected at days 0,4,7,and 15 after the beginning of enteral nutrition.Length of ICU stay was compared between groups.Results There were no significant differences of the two groups in terms of rate of abdominal distention,vomiting,gastric retention and diarrhea.However,less gastro-oesophageal reflux or constipation patients were observed in study group,as compared with control group (P ＜ 0.05).Time to first defecation and time to targeted nutritional goals were shorter in study group,as compared with control group (P ＜ 0.05).Levels of prealbumin and transferrin had no significant differences between the two groups at days 0,4,and 7,but study group showed both were higher than control group at day 15 (P＜0.05).Moreover,length of ICU stay showed no significant difference between the two groups.Conclusions Compared with simple enteral nutrition,early enteral nutrition with probiotics improves gastrointestinal motility,facilitates the delivery of enteral nutrition,and further ameliorates nutritional status in patients with severe craniocerebral trauma.