肠道功能训练对重型颅脑损伤患者肠道功能及肠道菌群的影响效果探究

Effects of intestinal function training on intestinal function and intestinal flora level in patients with severe craniocerebral injury

目的:探讨肠道功能训练(Intestinal Function Training,IFT)对重型颅脑损伤(Traumatic Brain Injury,TBI)患者肠道功能及肠道菌群的影响。方法:选取我科2021年收治的83例重型颅脑损伤患者,随机数字表法分为管理组和训练组。管理组41例给予常规肠内营养及肠道管理,训练组42例在管理组基础上给予联合IFT,对比两组临床结局、患者腹胀、便秘与排便情况、肠道功能、肠道菌群水平。结果:训练组的腹胀发生率和便秘次数低于管理组(P<0.05),训练组的自主排便率和每天排便≥1次率高于管理组(P<0.05)。训练组的Wexner便秘评分、神经源性肠道综合征症状评分均低于管理组(P<0.05)。训练组的双歧杆菌、乳酸杆菌水平高于管理组,肠球菌、大肠杆菌水平低于管理组(P<0.05)。结论:IFT能显著改善重型TBI患者的肠道功能障碍(Intestinal dysfunction,ID),能促进患者排便,减少腹胀发生,还有助于改善肠道微生态紊乱。

Objective:To investigate the effects of Intestinal Function Training(IFT)on intestinal function and intestinal flora in Traumatic Brain Injury(TBI)patients.Method:A total of 83 severe TBI patients admitted to our department from February 2021 to April 2021 were randomly divided into management group and training group.41 cases in the management group were given conventional enteral nutrition and intestinal management,and 42 cases in the training group were given combined IFT on the basis of management group.The clinical outcome,abdominal distension,constipation and defecation,intestinal function and intestinal flora level of the two groups were compared.Results:The frequency of abdominal distension and constipation in the training group was lower than that in the management group(P<0.05),and the rate of voluntary defecation and the rate of≥1 defecation per day in the training group were higher than those in the management group(P<0.05).Wexner constipation score and neurogenic intestinal syndrome symptom score in the training group were lower than those in the management group(P<0.05).The levels of Bifidobacterium and Lactobacillus in training group were higher than those in management group,while the levels of enterococcus and Escherichia coli in training group were lower than those in management group(P<0.05).Conclusions:IFT could significantly improve Intestinal dysfunction(ID)in the severe TBI patients,promoting bowel defecation and reducing abdominal distention,and contributing to improving intestinal microecological dysfunction.