鱼胶原低聚肽对急诊复杂手外伤手术患者预后的影响

Effects of fish collagen oligopeptide on operative prognosis of patients with emergency complex hand trauma

目的探讨早期肠内营养添加鱼胶原低聚肽对急诊复杂手外伤手术患者预后的影响。方法回顾性分析急诊收治的122例接受手术治疗的复杂开放性手外伤患者资料,所有患者术后均早期应用肠内营养制剂,根据配方不同分为2组。对照组60例,肠内营养配方为口服均衡营养素联合乳清蛋白;试验组62例,肠内营养配方为对照组配方加用鱼胶原低聚肽。比较2组患者临床基线资料,治疗前后血红蛋白(Hb)、淋巴细胞计数(Lym)、中性粒细胞与淋巴细胞比值(NLR)、白蛋白(ALB)、前白蛋白(PA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、尿素氮(BUN)、肌酐(Cr)、甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)等水平变化;比较2组患者住院时间和术后感染性并发症发生率。结果与治疗前比较,对照组和试验组营养治疗后Hb、ALB、肝肾功能及脂质代谢指标无显著变化,PA、Lym显著提高,NLR显著降低;治疗后与对照组相比,试验组NLR下降更明显(P<0.01)。试验组感染性并发症发生率低于对照组,住院时间缩短(P<0.05)。结论急诊复杂手外伤术后早期肠内营养添加鱼胶原低聚肽可促进PA合成,降低炎症反应及伤口感染发生率,缩短住院时间。

Objective To observe the effect of enteral nutrition with fish collagen oligopeptide on operative prognosis of patients with emergency complex hand trauma.Methods A total of 122 patients who suffered from complex hand trauma and were operated in the emergency department were retrospectively analyzed.Patients were given early enteral nutritional support after the operation,and were divided into two groups according to different formulations.The control group(60 patients)was given balance nutrients and whey protein,and the experimental group(62 patients)was given fish collagen oligopeptide on the same enteral nutrition formula.Clinical data were compared between the two groups,including hemoglobin(Hb),lymphocyte count(Lym),neutrophil-lymphocyte ratio(NLR),albumin(ALB),prealbumin(PA),alanine transaminase(ALT),aspartate transaminase(AST),urea nitrogen(BUN),creatinine(Cr),triglyceride(TG),total cholesterol(TC)and low density lipoprotein-C(LDL-C)before and after treatment.The length of hospital stay and the incidence of postoperative infectious complications were compared between the two groups of patients.Results Compared with before treatment,Hb,ALB,liver and kidney function and lipid metabolism indexes of the control group and the experimental group had no significant changes after nutritional treatment,and PA and Lym were significantly increased,and NLR was significantly decreased.After nutritional treatment,compared with the control group,NLR was decreased more significantly in the experimental group(P<0.01).The incidence of infectious complications was lower in the experimental group than that in the control group,and the length of hospitalization was significantly shortened(P<0.05).Conclusion Early enteral nutrition supplemented with fish collagen oligopeptide in patients with emergency complex hand trauma can promote prealbumin synthesis,reduce the incidence of inflammation and wound infection,and shorten hospital stay.