复合免疫营养对严重多发伤合并脓毒症患者的疗效观察

Clinic Study on Immunonutrition Combined Application of Kabiven and Omegaven in Perioperative Period on Severe Multiple Injuries Patients with Sepsis

目的:观察复合免疫营养治疗严重多发伤合并脓毒症患者的疗效。方法:严重多发伤合并脓毒症患者29例,将其随机分为对照组(n=14)和实验组(n=15)。对照组予以常规治疗,实验组在对照组基础上加用卡文和尤文行复合免疫营养治疗。观察所有患者治疗前及治疗一周后简化急性生理学评分Ⅱ(SAPSⅡ)、慢性健康状况评价Ⅱ(APACHEⅡ)、总蛋白(TP)、白蛋白(ALB)、促红细胞生成素(EPO)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、降钙素原(PCT)以及T淋巴细胞分子CD4+、CD8+及CD4+/CD8+比值的差异。结果:治疗一周后,实验组APACHEⅡ、SAPSⅡ、hs-CRP、TNF-α、CD4+细胞百分比和CD8+细胞百分比较治疗前及对照组治疗后均显著改善(P均<0.05)。TP、ALB和CD4+/CD8+比值与治疗前相比显著升高(P<0.05),IL-6和PCT与治疗前相比显著降低(P<0.05),但与对照组治疗后比较差异均无统计学意义(P>0.05);EPO与治疗前及对照组治疗后均无统计学差异(P>0.05)。结论:复合免疫营养治疗有助于维持机体免疫动态平衡及促炎和抗炎平衡,提高临床疗效。

Objective： To study the effect of combined application of kabiven and omegaven on severe multiple injuries patients with sepsis. Method： 29 severe multiple injuries patients with sepsis were randomly divided into two groups. Control group（n= 14） received conventional therapy, and the experimental group（n= 15） was treated with nutritional therapy combined application of kabiven and omegaven based on conventional therapy. The clinic index including SAPS II, APACHE II, TP, ALB, EPO, hs-CRP, TNF-α, IL-6, PCT, CD4^＋, CD8^＋, CD4^＋/CD8^＋ ratio were collected and compared before and after one week treatment. Results： By contrast, SAPS II , APACHE II , hs-CRP, TNF-α, CD4^＋ and CD8^＋ improved significantly both after treatment and compared with the control（P 〈0.05）; the level of TP, ALB and CD4^＋/CD8^＋ increased significantly, and level of IL-6 and PCT decreased significantly after treatment（P〈0.05）, but showed no significant difference as compared with the control（P〉0.05） the change of EPO showed no significant difference as compared （P〉0.05）. Conclusion： The immune nutrition therapy helps to prompt the body to restore homeostasis of proinflammatory and anti-inflammatory, and improve the clinic efficacy.