摘要
目的观察脑外伤患者经伤后早期生态免疫肠内营养治疗后,其营养及免疫状况。方法将2010年2月至2013年11月收治的75例脑外伤患者,随机分为3组,分别为普通肠内营养(EN)组,免疫肠内营养(IEN)组,生态免疫肠内营养(EIEN)组,每组25例。患者于伤后第2天开始实施营养治疗,共8 d。于伤后第2、4、6、8天检测各组患者外周血血清前白蛋白(PA)、视黄醇结合蛋白(RBP)浓度;检测外周血血清免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)和免疫球蛋白M(Ig M)浓度。对比分析各组患者的感染率及病死率,以及炎症反应综合征(SIRS)持续时间等。结果经早期营养支持治疗后,伤后第8天各组患者的血清Ig A、Ig G和Ig M及血清PA及RBP值均与伤后第2天比较,差异有统计学意义(P<0.01)。但EIEN组与其他2组比较,患者的SIRS持续时间短及感染并发症发生率低。结论 EIEN较IEN及EN在改善脑外伤患者免疫状况及提高患者的临床预后方面更有优势。
Objective To evaluate the therapeutic effect of early ecological immune enteral nutrition （EIEN） on ameliora- ting malnutrition and immunosuppression on the patients with traumatic brain injury （TBI）. Methods All 75 TB! patients were randomly divided into 3 groups,included EIEN group, IEN group （ immune enteral nutrition） and EN group （ enteral nutrition）. There were 25 cases in each group respectively. All TBI patients were treated with nutritional support since the second day post-injury. On 2,4,6 and 8 days post-injury, the serum concentration of IgA, IgG and IgM as well as the serum concentration of PA and RBP were detected by automatic biochemical analyzer. The infection rate, mortality rate and the du- ration of SIRS were evaluated on all TBI patients. Results After early nutrition support treatment with EIEN, IEN and EN, the serum concentration of IgA, IgG and IgM as well as the serum concentration of PA and RBP were obviously elevated on the eighth day versus that on the second day post-injury （P 〈 0.01 ）. The infected rate reduced on TBI patients treated with EIEN compared with IEN or EN. Furthermore, the duration of SIRS decreased. Conclusion When compared to IEN or En, EIEN is more effective in improving the immunosuppression and clinical prognosis on TBI patients.
出处
《创伤与急危重病医学》
2015年第2期101-103,共3页
Trauma and Critical Care Medicine
关键词
生态免疫肠内营养治疗
脑外伤
免疫抑制
营养不良
ecological immune enteral nutrition therapy
cerebral trauma
immunosuppression
malnutrition
