谷氨酰胺与双歧杆菌三联活菌联合强化早期肠内营养支持在重症脑梗死患者中的应用价值

Application Value of Glutamine Combined with Bifidobacterium Triple Viable BacteriaEnhanced Early Enteral Nutrition Support in Patients with Severe Cerebral Infarction

目的探究谷氨酰胺与双歧杆菌三联活菌联合强化早期肠内营养支持在重症脑梗死(SCI)患者中的应用价值。方法回顾性选取郑州大学第一附属医院2021年10月至2023年6月收治的95例SCI患者,根据治疗方案分为对照组(47例)和研究组(48例)。对照组接受谷氨酰胺强化早期肠内营养支持,研究组在对照组基础上联合双歧杆菌三联活菌肠溶胶囊强化干预。比较两组治疗前后肠道屏障功能指标[二胺氧化酶(DAO)、D-乳酸、内毒素]、免疫指标[免疫球蛋白(Ig)A、IgG]、肠道菌群菌落数(双歧杆菌、乳酸杆菌、肠球菌)、营养状态指标(血红蛋白、白蛋白、总蛋白)、感染发生情况。结果治疗2周及4周后,研究组血清DAO、内毒素、D-乳酸水平低于对照组,双歧杆菌、乳酸杆菌、肠球菌菌落数、血清IgA、IgG水平、血红蛋白、白蛋白、总蛋白水平均高于对照组(P<0.05);研究组感染发生率低于对照组(P<0.05)。结论谷氨酰胺与双歧杆菌三联活菌联合强化早期肠内营养支持应用于SCI患者中,可有效改善肠道菌群失调,提升机体抵抗力,恢复肠道屏障功能,改善营养不良状态,降低感染风险。

Objective To explore the effects of glutamine combined with probiotics enhanced early enteral nutrition support in patients with severe cerebral infarction(SCI).Methods A total of 95 patients with SCI admitted to the First Affiliated Hospital of Zhengzhou University from October 2021 to June 2023 were collected retrospectively,and they were divided into control group(47 cases)and study group(48 cases)according to different treatment methods.The control group was given glutamine enhanced early enteral nutrition support,and the study group was given glutamine combined with bifidobacterium triple viable enteric capsule enhanced early enteral nutrition support.Intestinal barrier function indexes[diamine oxidase(DAO),D-lactic acid,endotoxin],immune indexes[immunoglobulin(Ig)A,IgG],intestinal flora number(bifidobacterium,lactobacillus,enterococcus),and nutritional status indexes(hemoglobin,albumin,total protein)before and after treatment,infection occurrence were compared between the two groups.Results After 2 and 4 weeks of treatment,the serum levels of DAO,endotoxin and D-lactic acid in the study group were lower than those in the control group,while the number of bifidobacterium,lactobacillus and enterococcus colonies,serum levels of IgA,IgG,levels of hemoglobin,albumin and total protein were higher than those in the control group(P<0.05).The incidence of infection in the study group was lower than that in the control group(P<0.05).Conclusion Glutamine combined with bifidobacterium triple viable bacteria enhanced early enteral nutrition support in patients with SCI can effectively improve intestinal flora disorders,improve body resistance,restore intestinal barrier function,reduce the risk of infection.