不同肠内营养制剂早期联合双歧杆菌三联活菌对脑出血术后患者营养及炎症反应的影响

Different kinds of early enteral nutrition combined with Bifidobacterium triple viable mixture on the nutritional status and inflammation reaction of the patients after cerebral hemorrhage operation

目的:探讨不同种类的肠内营养制剂早期联合双歧杆菌三联活菌对脑出血术后患者的营养状况、免疫功能的影响。方法:将80例脑出血术后患者随机分成4组,普通肠内营养组、短肽类肠内营养组、普通肠内营养加双歧杆菌三联活菌组和短肽类肠内营养加双歧杆菌三联活菌组,于手术术后当天及术后第7天分别测定两组白蛋白(ALB)、前白蛋白(PA)、血清运铁蛋白(Tf)、C反应蛋白(CRP)、CD8、CD4,同时分别对两组患者的胃肠道症状包括腹泻、便秘、胃潴留、消化道出血情况进行评价。结果:术后第7天,与普通肠内营养组相比,短肽类肠内营养组前白蛋白增高(P<0.05),但白蛋白、血清运铁蛋白、CRP、T细胞亚群均与普通肠内营养组相比均差异无统计学意义(P>0.05);普通肠内营养加双歧杆菌三联活菌组与普通肠内营养组相比,白蛋白、前白蛋白、血清运铁蛋白、CRP均增高(P<0.05),但CD8、CD4与普通肠内营养组相比差异无统计学意义(P>0.05);短肽类肠内营养加双歧杆菌三联活菌组与短肽类肠内营养组相比白蛋白、前白蛋白、血清运铁蛋白、CRP均增高(P<0.05),但CD8、CD4与短肽类肠内营养组相比差异无统计学意义(P>0.05)。与普通肠内营养相比,短肽类肠内营养可提高患者前白蛋白的水平,不论何种肠内营养早期联合双歧杆菌三联活菌不仅可减轻胃肠道症状,还可以改善营养水平,一定水平上可以减轻炎症反应。结论:针对脑出血术后的患者与普通肠内营养相比,短肽类肠内营养可提高患者前白蛋白的水平,不论何种肠内营养早期联合双歧杆菌三联活菌不仅可减轻胃肠道症状,还可以改善营养水平,一定水平上可以调节免疫。

Objective：To investigate the influences of different kinds of early enteral nutrition combined with Bifidobacterium triple viable mixture on curative effect of patients after cerebral hemorrhage operations.Method：Eighty patients after cerebral hemorrhage operation have been randomly divided into 4 groups,which were respectively given normal enteral nutrition,oligopeptides enteral nutrition,and normal enteral nutrition with Bifidobacterium triple viable mixture and oligopeptides enteral nutrition with Bifid Triple Viable.Albumin（ALB）,Prealbumin（PA）,Transferrin（TF）,C-reactive protein（CRP）,CD8,and CD4 in blood were measured on days 0 and 7 after cerebral hemorrhage operations,and gastrointestinal symptoms of patients including diarrheal,constipation,gastric retention and gastrointestinal bleeding were evaluated.Result：On the day 7 after cerebral hemorrhage operations,the PA values of patients from the group which was given oligopeptides enteral nutrition were higher than that from the group which was given normal enteral nutrition（P〈0.05）,but there were no statistic differences in the values of ALB,Tf,CRP and T-cell subset between above two groups.Compared to the group which was given normal enteral nutrition,the ALB,PA,Tf and CPR values of patients from the group which was given normal enteral nutrition with Bifidobacterium triple viable mixture are higher（P〈0.05）,but there were no statistic differences in the values of CD8 and CD4 between these two groups.The ALB,PA,Tf and CRP values of patients from the group which was given oligopeptides enteral nutrition with Bifidobacterium triple viable mixture were higher than that from the group which was given oligopeptides enteral nutrition（P〈0.05）,but there were no statistic differences in the values of CD8 and CD4 between above two groups.And early enteral nutrition combined with Bifidobacterium triple viable mixture in the treatment of patients can help to reduce gastrointestinal symptoms,such as constipation,diarrheal,gastric retention.Conclusion：Oligopeptides enteral nutrition can improve the PA state in patients after cerebral hemorrhage operations.Using early enteral nutrition combined with Bifidobacterium triple viable mixture in treatment of patients after cerebral hemorrhage operations can not only improve patients＇ nutritional status and reduce their gastrointestinal symptoms,but also help to alleviate the inflammation reaction to some extent