添加益生菌联合肠内营养对急性创伤性颅脑损伤患者凝血功能、胃肠功能和炎性因子的影响

Effects of enteral nutrition containing probiotics on coagulation function,gastrointestinal function and inflammatory factors in patients with acute traumatic brain injury

目的探讨添加益生菌联合肠内营养对急性创伤性颅脑损伤患者凝血功能、胃肠功能和炎性因子的影响。方法收集2021年1月至2022年12月绍兴市中心医院急诊监护室收治的急性创伤性颅脑损伤患者100例,分为观察组与对照组各50例。对照组给予早期肠内营养,观察组在对照组基础上给予双歧杆菌三联活菌肠溶胶囊自鼻饲管注入。2组疗程均为14 d。比较两组治疗前后凝血功能、胃肠功能和炎性因子变化、胃肠并发症发生情况。结果两组治疗后Fib和D-二聚体(D-D)水平均低于治疗前(均P<0.05);观察组治疗后Fib和D-D水平均低于对照组(均P<0.05)。两组治疗后胃泌素(GAS)、血管活性肠肽(VIP)水平均低于治疗前,而胃动素(MTL)水平均高于治疗前(均P<0.05);观察组治疗后GAS和VIP水平均低于对照组,而MTL水平高于对照组(均P<0.05)。两组治疗后CRP、IL-6和IL-8水平均低于治疗前(均P<0.05);观察组治疗后CRP、IL-6和IL-8水平均低于对照组(均P<0.05);观察组胃肠并发症发生率低于对照组(P<0.05)。结论急性创伤性颅脑损伤患者采用添加益生菌联合肠内营养可改善患者凝血功能和胃肠功能,减轻患者炎性反应。

Objective To investigate the effect of enteral nutrition containing probiotics on coagulation function,gastrointestinal function and inflammatory factors in patients with acute traumatic brain injury.Methods One hundred patients with acute traumatic brain injury admitted in Shaoxing Central Hospital from January 2021 to December 2022 were divided into study group and control group with 50 cases in each group.The early enteral nutrition was given to both groups,and the additional bifid triple viable enteric coated capsules were given to study group.The treatment course lasted for 14 d.The coagulation function,gastrointestinal function and inflammatory factors before and after treatment were compared in two groups;and gastrointestinal complications were compared between two groups.Results The Fib and D-D levels were decreased after treatment in both groups(all P<0.05);and the Fib and D-D levels in study group were lower than those in control group(both P<0.05).The GAS and VIP levels were decreased,and MTL level was increased after treatment in both groups(all P<0.05);while the GAS and VIP levels in study group were lower,and MTL level was higher than those in control group(all P<0.05).The CRP,IL-6 and IL-8 levels were decreased after treatment in both groups(all P<0.05);while the above indicators in study group were lower than those in control group(all P<0.05).The incidence of gastrointestinal complications in study group was lower than that in control group(P<0.05).Conclusion The combination of probiotics and enteral nutrition can further improve the coagulation and gastrointestinal function,and reduce the inflammatory reaction of patients with acute traumatic brain injury.