蕊福平治疗重症患者使用肠内营养引起的腹泻临床疗效

The clinical efficacy of REF-P1 on the treatment of enteral nutrition-induced diarrhea in severe patients

目的观察蕊福平作为重要的低甲氧基果胶在治疗重症患者使用肠内营养过程中引起腹泻的临床疗效。方法通过电子病历数据库收集2017年1月1日至2019年6月30日在该院EICU、ICU病房住院期间使用肠内营养出现腹泻的患者,除去感染性腹泻、未使用蒙脱石散或蕊福平治疗的患者及出现腹泻后由于病情较重未到观察终点自动放弃治疗的患者,共172例。根据患者的APACHEⅡ评分把患者分为两组,APACHEⅡ<20组、APACHEⅡ≥20组。各组内再分为蒙脱石散治疗组、蕊福平治疗组、蒙脱石散+蕊福平治疗组,记录改善比、改善时间、便秘比、肠内营养足量时间之间的差异进行统计分析,分析蕊福平在重症患者肠内营养过程中腹泻的治疗效果。结果蕊福平治疗组、蒙脱石散+蕊福平治疗组与蒙脱石散治疗组相比较,腹泻症状改善明显,差异有统计学意义(P<0.05);蕊福平治疗组、蒙脱石散+蕊福平治疗组和蒙脱石散治疗组相比较,改善时间、肠内营养足量时间均明显缩短,便秘比明显减少,差异均有统计学意义(P<0.05);蕊福平治疗组与蒙脱石散+蕊福平治疗组比较,便秘比、肠内营养足量时间明显减少,差异有统计学意义(P<0.05),而改善比、改善时间差异均无统计学意义(P>0.05)。蒙脱石散治疗无改善,改为蕊福平或蒙脱石散+蕊福平治疗,患者腹泻均改善明显,两组间改善时间差异无统计学意义(P>0.05);蒙脱石散+蕊福平治疗组和蕊福平治疗组相比较,便秘比、肠内营养足量时间均明显增加,差异有统计学意义(P<0.05)。结论蕊福平对重症患者使用肠内营养过程中引起的腹泻有一定的疗效,同时可以减少便秘发生率。

Objective To investigate the efficacy of REF-P1 as the core of low-methoxyl pectin on enteral nutrition-induced diarrhea in severe patients.Methods A retrospective clinical study were conducted in 172 patients with diarrhea in the use of enteral nutrition in the emergency intensive care unit(EICU)or intensive care unit(ICU)between January 2017 and June 2019.Those with infective diarrhea,not using smecta or REF-P1,and who give up treatment automatically after the onset of diarrhea due to severe illness were excluded.The patients were divided into APACHEII<20 and APACHEII≥20 according to APACHEII score.And they were further divided into smecta treatment group,REF-P1 treatment group,and smecta+REF-P1 treatment group.The improvement ratio,improve time,constipation ratio and the days to reach the target of enteral nutrition were compared.Results REF-P1 treatment group and smecta+REF-P1 treatment group significantly improved the symptoms of diarrhea more than smecta treatment group(P<0.05).The improve time and the days to reach the target of enteral nutrition were significantly shortened,and the constipation ratio reduced in REF-P1 treatment group and smecta+REF-P1 treatment group,comparing with smecta treatment group(P<0.05).The constipation ratio,and the days to reach the target of enteral nutrition were significantly reduced in REF-P1 treatment group,comparing with smecta+REF-P1 treatment group(P<0.05).But there was no significant difference in improvement ratio and improvement days(P>0.05).The constipation ratio and the days to reach the target of enteral nutrition were significantly improved in REF-P1 treatment group,comparing with smecta+REF-P1 treatment group(P<0.05).Conclusion The REF-P1 provides good clinical efficacy on the treatment of diarrhea in severe patients,and can reduce the constipation ratio.