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Received:February 04, 2024 Published Online:November 20, 2024
Received:February 04, 2024 Published Online:November 20, 2024
中文摘要: 目的 探讨早期肠内营养（EEN）联合益生菌对严重多发伤患者治疗效果及预后的影响。方法 纳入2022年7月至2023年7月就诊于达州市中心医院重症医学科创伤严重程度评分表＞16分的多发伤患者110例，采用随机数字表法分为对照组（55例）和观察组（55例）。对照组行EEN支持，观察组行EEN联合益生菌营养支持。比较两组患者治疗前后血清二胺氧化酶（DAO）、D-乳酸（D-La）、总蛋白（PB）、前白蛋白（PAB）、C反应蛋白（CRP）、白细胞计数（WBC），统计两组患者ICU住院时间、胃肠道不良事件发生率以及28 d死亡率。 结果 两组患者治疗后血清DAO、D-La、CRP、WBC均低于治疗前，且观察组低于对照组［（7.77±1.03）ng/L vs （8.84±0.63）ng/L，（48.25±7.23） mg/L vs （53.85±6.44） mg/L，（33.43±17.28）mg/L vs （43.44±19.13） mg/L，（7.48±1.56）×109/L vs （9.77±1.30）×109/L］，差异有统计学意义（P＜0.05）；两组患者治疗后TP、PAB均高于治疗前，且观察组高于对照组［（58.80±2.83）g/L vs （54.43±2.06） g/L，（175.93±5.78） g/L vs （159.16±8.06）g/L］，差异有统计学意义（P＜0.05）；观察组患者胃肠道不良事件发生率低于对照组（26.1% vs 46.5%），差异有统计学意义（P＜0.05）。两组患者ICU住院时间、28 d死亡率差异无统计学意义（P＞0.05）。结论 EEN联合益生菌可以有效保护严重多发伤患者的肠道黏膜屏障，改善患者的营养状态，降低胃肠道不良事件的发生率，但对严重多发伤患者ICU住院时间以及28 d死亡率无明显影响。
Abstract:Objective To investigate the effect and prognosis of early enteral nutrition (EEN) combined with probiotics on patients with severe multiple injuries. Methods A total of 110 patients with multiple injuries who scored＞16 points on the trauma severity score in the Intensive Care Unit of Dazhou Central Hospital from July 2022 to July 2023 were collected and divided into control group (55 cases) and observation group (55 cases) using a random number table method. The control group received EEN support, while the observation group received EEN combined with probiotic nutritional support. Serum diamine oxidase (DAO), D-lactic acid (D-La), total protein (PB), prealbumin (PAB), C-reactive protein (CRP), and white blood cell count (WBC) were compared between the two groups before and after treatment. The length of ICU stay, incidence of gastrointestinal adverse events, and 28-day mortality rate were statistically analyzed for both groups. Results After treatment, serum DAO, D-La, CRP, and WBC levels in both groups were lower than before treatment, with the observation group having lower levels than the control group ［(7.77±1.03) ng/L vs (8.84±0.63) ng/L, (48.25±7.23) mg/L vs (53.85±6.44) mg/L, (33.43±17.28) mg/L vs (43.44±19.13) mg/L, (7.48±1.56)×109/L vs (9.77±1.30)×109/L］, with a significant difference (P＜0.05); post-treatment TP and PAB levels in both groups were higher than before treatment, with the observation group having higher levels than the control group ［(58.80±2.83) g/L vs (54.43±2.06) g/L, (175.93±5.78) g/L vs (159.16±8.06) g/L］, with a significant difference (P＜0.05); the incidence of gastrointestinal adverse events in the observation group was lower than that in the control group (26.1% vs 46.5%), with a significant difference (P＜0.05); however, there was no significant difference in ICU stay or 28-day mortality rate between the two groups (P＞0.05). Conclusion EEN combined with probiotics can effectively protect the intestinal mucosal barrier of patients with severe multiple injuries, improve their nutritional status, and reduce the incidence of gastrointestinal adverse events, but it has no significant impact on the ICU stay or 28-day mortality rate of patients with severe multiple injuries.
keywords: Multiple injuries Probiotics Early enteral nutrition Intestinal barrier Nutritional status
文章编号： 中图分类号：R641 文献标志码：A
基金项目:四川青年创新科研课题计划基金项目（Q20077）
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