早期肠内营养对休克后患者炎性反应的疗效研究

Study of the effects of early enteral nutrition on the inflammatory response after shock

目的研究早期肠内营养(EN)对休克患者内毒素及肿瘤坏死因子-α(TNF-α)的作用及全身炎性反应综合征(SIRS)的影响。方法休克67例随机分为早期EN组和肠外营养(TPN)组,检测两组患者肠内营养治疗前、治疗后1、3、5 d血浆中内毒素与TNF-α水平;统计两组SIRS的持续时间与多器官功能障碍(MODS)的发生率。结果早期EN组患者5 d后血浆内毒素与TNF-α明显低于TPN组(P<0.01),SIRS的持续时间与MODS的发病率均低于TPN组(P<0.05)。结论早期肠内营养可显著降低休克后患者血浆内毒素及TNF-α水平,缩短了SIRS的持续时间,降低了MODS的发生率。

Objective To study the therapeutic effects of early enteral nutrition on the serum endotoxin,tumor necrosis fator-α(TNF-α) and systemic inflammatory response syndrome(SIRS) of patients after shock.Methods Sixty-seven patients were randomly divided into early enteral nutrition group and total parenteral nutrition(TPN) group after shock.The serum endotoxin and TNF-α level were detected at 0 d,1 d,3 d and 5 d respectively.The duration of SIRS and the morbidity rates of multiple organ dysfunction syndrome(MODS) were compared between two groups.Results The serum endotoxin and TNF-α level of patients suffered from shock in EN group were obviously lower than those in TPN group after 5 days(P<0.01).The duration of SIRS and the morbidity rates of MODS in EN group were lower than those in TPN group(P<0.05).Conclusion Early enteral nutrition can decrease the serum endotoxin and TNF-α level in shock patients,which is redound to attenuate the SIRS and decrease morbidity the rate of MODS.