益生菌强化肠内营养支持对重度颅脑损伤患者肠黏膜屏障功能及炎症因子的影响

Effect of probiotics enhance enteral nutrition support on intestinal mucosal barrier function and inflammatory factors in patients with severe craniocerebral injury

目的探讨益生菌强化肠内营养支持对重度颅脑损伤患者肠黏膜屏障功能及炎症因子的影响。方法选择2017年4月—2019年4月南通大学附属建湖医院收治的重度颅脑损伤患者105例,按照随机数字表法分为对照组(52例)和观察组(53例)。对照组采用肠内营养支持治疗,观察组给予益生菌强化肠内营养支持治疗,两组均连续治疗1个月。比较两组治疗前后的格拉斯哥(GCS)评分及血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、D-乳酸、前降钙素(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平。比较两组治疗1个月后的感染发生率和并发症发生率。结果治疗后,两组GCS评分、血清IgA、IgG及IgM水平均高于治疗前,同时观察组高于对照组,差异均有统计学意义(均P <0.05)。治疗后,两组血清D-乳酸、PCT、TNF-α、IL-6水平均低于治疗前,同时观察组低于对照组,差异均有统计学意义(均P <0.05)。治疗后,观察组感染发生率和并发症发生率均低于对照组,差异均有统计学意义(均P <0.05)。结论益生菌强化肠内营养支持治疗重度颅脑损伤患者,能够减轻意识障碍程度,提高免疫功能和肠黏膜屏障功能,抑制机体炎症反应,减少感染和并发症的发生。

Objective To explore the effect of probiotics enhance enteral nutrition support on intestinal mucosal barrier function and inflammatory factors in patients with severe craniocerebral injury. Methods According to the random number table method, 105 cases of patients with severe craniocerebral injury admitted to Jianhu Hospital Affiliated to Nantong University from April 2017 to April 2019 were selected and divided into control group(52 cases) and observation group(53 cases). The control group was treated with enteral nutrition support, while the observation group was treated with probiotics enhance enteral nutrition support. The two groups were treated for one month. The Glasgow(GCS) scores and serum levels of immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), D-lactic acid, procalcitonin(PCT), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) were compared between the two groups before and after treatment. The Incidence of infection and complications after one month of treatment were compared between the two groups. Results After treatment, GCS score, the serum levels of IgA, IgG, IgM of the two groups were all higher than those before treatment, while those in the observation group were higher than those in the control group,with statistically significant differences(all P < 0.05). After treatment, the serum levels of D-lactic acid, PCT, TNF-αand IL-6 in the two groups were all lower than those before treatment, while those in the observation group were lower than those in the control group, with statistically significant differences(all P < 0.05). After treatment, the incidence of infection and complications in the observation group was lower than that in the control group, with statistically significant differences(all P < 0.05). Conclusion Probiotics enhance enteral nutrition support in treatment of patients with severe craniocerebral injury can reduce the degree of disturbance of consciousness, improve the immune function and intestinal mucosal barrier function, inhibit the inflammatory reaction, reduce the incidence of infection and complications.