四联益生菌联合低聚半乳糖预防颅脑内伤重症患者腹泻研究

Tetralogy probiotics combined with galactooligosaccharides in prevention of diarrhea in patients with severe craniocerebral injury

目的观察四联益生菌和低聚半乳糖对颅脑内伤ICU重症患者腹泻的影响。方法采用病例对照研究,纳入因颅脑内伤入住第二附属医院神经内科重症加护病房(ICU)危重症患者共90例,按随机数字表法分为试验组和对照组(n=45)。对照组采用常规营养治疗,试验组采用常规营养治疗联合四联益生菌和低聚半乳糖,两组均通过鼻胃管连续滴注肠内营养液治疗5 d,记录患者腹泻情况、ICU停留时间、胃管留置时间、血清总蛋白(total serum protein,TP)、血清白蛋白(serum albumin,ALB)、血清前白蛋白(prealbumin,PA)等并进行比较。结果试验组腹泻发生率显著低于对照组(2.22%vs 17.78%,P<0.05)。试验组的胃管留置时间显著短于对照组[(10.04±5.39)d vs(14.27±8.14)d,P<0.01]。营养治疗前对照组和试验组TP、ALB、PA相比差异无统计学意义(P>0.05)。营养治疗第5天试验组的PA明显高于对照组[(180.50±58.73)mg/L vs(169.55±67.85)mg/L,P<0.01]。结论在使用肠内营养滴注的同时加用四联益生菌和低聚半乳糖可以有效预防神内重症患者出现腹泻症状,改善营养状况,缩短胃管留置时间。

Objective To observe the clinical effect of tetralogy probiotics combined with galactooligosaccharides on diarrhea in patients after severe craniocerebral injury.Methods A case-control study was conducted on 90 patients with severe craniocerebral injury admitted in the intensive care unit(ICU)of neurological department of our hospital during January to June 2019.They were randomly divided into control and experimental groups,with 45 patients in each group.The patients of the former group was given conventional nutrition therapy,while those of the latter group were treated with conventional nutrition therapy combined with tetralogy probiotics and galactooligosaccharides.After 5 days’enteral nutrition through nasogastric tube,occurrence of diarrhea,ICU duration,indwelling time of gastric tube,and serum levels of total serum protein(TP),albumin(ALB)and prealbumin(PA)were recorded and compared between the 2 groups.Results The experimental group had significantly lower incidence of diarrhea(2.22%vs 17.78%,P<0.05),and shorter indwelling time of gastric tube(10.04±5.39 vs 14.27±8.14 d,P<0.01)when compared with the control group.There were no statistical differences in the TP,ALB and PA levels between the 2 groups before nutrition treatment(P>0.05).On the 5 th day post nutritional treatment,the PA level of the experimental group was obviously higher than that of the control group(180.50±58.73 vs 169.55±67.85 mg/L,P<0.01).Conclusion Conventional nutrition therapy combined with tetralogy probiotics and galactooligosaccharides can effectively prevent diarrhea in patients after severe craniocerebral injury,improve their nutritional status and shorten the indwelling time of gastric tube.