益生菌联合谷氨酰胺在重型颅脑损伤中的应用效果分析

Therapeutic Effect of Probiotics Combined with Glutamine in the Treatment of Severe Craniocerebral Injury

目的探讨益生菌联合谷氨酰胺在重型颅脑损伤中的治疗效果。方法选取2019年3月至2021年3月西平县中医院收治的66例重型颅脑损伤患者作为研究对象,按照随机数表法将其随机分为观察组(34例)和对照组(32例)。两组患者除给予机械通气、抗感染、开颅手术等治疗外,观察组患者采用常规肠内营养联合益生菌与谷氨酰胺治疗,对照组患者单纯采用常规肠内营养治疗,对比两组患者治疗前后的肠黏膜屏障功能、营养状况及免疫功能。结果治疗第3、7、14天,观察组患者乳果糖排泄率、血浆二胺氧化酶(DAO)水平均明显低于对照组(治疗第3天:t=5.071、2.054,P<0.001、P=0.044;治疗第7天:t=6.299、4.526,P均<0.001;治疗第14天:t=9.333、5.404,P均<0.001)。治疗第14天,两组患者白蛋白(ALB)、转铁蛋白(TRF)、前白蛋白(PAB)以及免疫球蛋白(Ig)A、IgG、IgM水平均明显高于治疗前,且观察组均明显高于对照组(t=4.750、3.613、9.147、6.948、7.435、5.407,P均<0.001)。结论益生菌联合谷氨酰胺治疗重型颅脑损伤,可有效保护患者肠黏膜屏障功能,改善机体营养状况,提高免疫功能。

Objective To study the therapeutic effect of probiotics combined with glutamine in the treatment of severe craniocerebral injury.Methods 66 patients with several craniocerebral injury,admitted into Xiping Hospital of Chinese Medicine between March 2019 and March 2021 were enrolled as research subjects,and divided into observation group(n=34)and control group(n=32)using the random number table.In addition to mechanical ventilation,infection control and craniotomy,patients were given probiotics and glutamine plus the conventional enteral nutrition therapy in observation group,while patients in control group were given the conventional enteral nutrition therapy alone.The intestinal mucosal barrier function,nutritional status and immune function of patients before and after treatment were compared between the two groups.Results On day 3,7 and 14 of treatment,the lactulose excretion rates and levels of plasma diamine oxidase(DAO)of patients were obviously lower in observation group than control group(Day 3:t=5.071,2.054,P<0.001,P=0.044;Day 7:t=6.299,4.526,bothP<0.001;Day 14:t=9.333,5.404,bothP<0.001).On day14 of treatment,the levels of albumin(ALB),transferrin(TRF),prealbumin(PAB)and immunoglobulin(Ig)A,IgG and IgM in both groups were markedly higher than that before treatment,and the levels in observation group were significantly higher than control group(t=4.750,3.613,9.147,6.948,7.435 and 5.407,allP<0.001).Conclusion The combined application of probiotics and glutamine in the treatment of severe craniocerebral injury can effectively protect the intestinal mucosal barrier function of patients,improve their nutritional status and enhance their immune functions.