早期肠内营养对重症监护室重症颅脑外伤患者炎症因子的影响分析

The effects of early enteral nutrition on inflammatory cytokines in ICU patients with severe craniocerebral trauma

目的探讨对重症监护室重症颅脑外伤患者采用早期肠内营养对患者炎症因子、免疫功能、营养状况的影响。方法选择2016年2月至2018年3月我院重症监护室收治的重症颅脑外伤患者50例,按照随机数字表法分为肠外组和肠内组各25例。肠外组给予肠外营养支持,肠内组给予早期肠内营养支持,比较两组患者的炎症因子、免疫功能、营养状况改善情况。结果治疗后,两组白介素(IL)-2、IL-6、IL-8、肿瘤坏死因子(TNF)-α水平均较治疗前降低,且肠内组比肠外组下降幅度更大(P<0.05);两组IgG、IgM、IgA、TLC及血红蛋白、前白蛋白、白蛋白水平均较治疗前升高,肠内组比肠外组升高幅度更大(P<0.05)。结论对重症监护室重症颅脑外伤患者中采用早期肠内营养,能降低患者炎症因子,提高患者自身的免疫能力,值得临床上进行推广。

Objective To analyze the effect of early enteral nutrition on inflammatory factors,immunologic function and nutritional status in ICU patients with severe craniocerebral trauma.Methods A total of 50 patients with severe craniocerebral trauma treated in ICU of our hospital from February 2016 to March 2018 were divided into parenteral group and enteral group,25 in each group.The parenteral group was given parenteral nutrition support,and the enteral group was given early enteral nutrition support.Inflammatory cytokines,immunologic function and nutritional status were compared between the two groups.Results After treatment,the levels of IL-2,IL-6,IL-8 and TNF-αin the two groups were significantly decreased when compared to before treatment,and the decreasing amplitude was bigger in the enteral group than that in the parenteral group(P<0.05).The levels of IgG,IgM,IgA,TLC,hemoglobin,prealbumin and albumin in the two groups were risen when compared to before treatment,and the ascending amplitude was bigger in the enteral group than that in the parenteral group(P<0.05).Conclusion The use of early enteral nutrition in the treatment of ICU patients with severe craniocerebral trauma can reduce the inflammatory factors and improve the immunity of the patients.It is worthy of clinical promotion.