肠内营养在腹腔感染继发心力衰竭中的临床应用

The clinical application of enteral nutrition in heart failure secondary to abdominal infection

目的分析肠内营养支持治疗腹腔感染继发心力衰竭患者的疗效及安全性。方法选取2018年1月至2019年12月期间在中国人民解放军联勤保障部队第九四〇医院住院治疗的腹腔感染继发心力衰竭患者50例,分为常规治疗组(n=25)和营养治疗组(n=25)。监测两组治疗前后B型钠尿肽(BNP)、左心室射血分数(LVEF)、白蛋白(ALB)、总胆红素(TBIL)、天门冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)和白介素6(IL-6)等指标的变化。结果两组基线资料差异无统计学意义。通过治疗前后比较发现,与常规治疗组相比,肠内营养治疗组的血浆BNP明显下降(59.60±21.58 vs 122.44±19.56,P<0.05),左心室射血分数提升(59.20±2.08 vs 50.28±2.21,P<0.05),白介素6降低(5.7±0.61 vs 7.56±0.97,P<0.05),白蛋白升高(35.56±2.68 vs 33.68±2.50,P<0.05),总胆红素(14.75±2.67 vs 23.66±3.08,P<0.05)、天门冬氨酸转氨酶(42.48±1.81 vs 49.52±3.39,P<0.05)和丙氨酸氨基转移酶(33.20±2.74 vs 47.48±6.62,P<0.05)均下降,差异均有统计学意义。结论在心衰药物治疗的基础上,早期提供肠内营养支持治疗可以改善腹腔感染继发心力衰竭患者的全身营养不良状况,有效控制机体感染,显著提升心功能和肝功能、增强机体免疫功能、减少术后并发症和有助于患者早日康复,在临床上值得推广和应用。

Objective To analyze the efficacy and safety of enteral nutrition support in the treatment of patients with heart failure secondary to abdominal infection.Methods From January 2018 to December 2019,50 patients with heart failure secondary to abdominal infection hospitalized in the People′s Liberation Army Joint Logistics Support Unit 940 Hospital were selected and divided into the conventional treatment group(n=25)and nutrition treatment group(n=25).The B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),albumin(ALB),total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and changes in indicators such as interleukin 6(IL-6)were monitored in both groups before and after treatment.Results There was no statistically significant difference in baseline data between the two groups.It was found before and after treatment that compared with the conventional treatment group,the plasma BNP of the enteral nutrition treatment group was significantly decreased(59.60±21.58 vs 122.44±19.56,P<0.05),and the left ventricular ejection fraction increased(59.20±2.08 vs 50.28±2.21,P<0.05),interleukin 6 decreased(5.7±0.61 vs 7.56±0.97,P<0.05),albumin increased(35.56±2.68 vs 33.68±2.50,P<0.05),total bilirubin(14.75±2.67 vs.23.66±3.08,P<0.05),aspartate aminotransferase(42.48±1.81 vs 49.52±3.39,P<0.05)and alanine aminotransferase(33.20±2.74 vs 47.48±6.62,P<0.05)all decreased,and the differences are statistically significant.Conclusion On the basis of heart failure drug treatment,early enteral nutrition support treatment can improve the systemic malnutrition of patients with heart failure secondary to abdominal infection,effectively control infections,significantly improve heart and liver functions,enhance immune function,and reduce Postoperative complications and help patients recover as soon as possible,are worthy of promotion and application in clinical practice.