早期肠内营养治疗对预防脑出血患者肠屏障损害的效果分析
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摘要
目的:探讨脑出血后给予早期肠道营养预防肠屏障发生损害的临床价值。方法 :选择2016年1月—2018年3月来我院神经外科住院的240例脑出血患者为研究对象,按照数字表随机分组的方法分为两组,各120例。对照组患者予常规肠外营养,观察组患者予早期肠内营养。结果:两组患者肺部感染、心功能衰竭、消化道症状、电解质紊乱等并发症发生情况比较差异均无统计学意义(P>0.05);两组治疗后L/M均比治疗前显著降低(P<0.05),且观察组治疗后L/M值显著低于对照组(P<0.05),说明肠内营养明显改善了肠黏膜通透性。结论:早期肠内营养治疗对患者的身体营养状况有一定的改善作用,对脑出血后的肠屏障有维护其完整性及正常功能的作用。
Objective : To explore the clinical value of early enteral nutrition in preventing intestinal barrier damage after cerebral hemorrhage. Methods : Nutrition therapy for 240 cases of cerebral hemorrhage patients in the neurosurgical department of our hospital from January 2016 to March 2018 were analyzed and assessed, all patients according to the digital table randomized divided into observation group(n=120) and the control group(n=120). Patients in the control group were given clinical routine parenteral nutrition. The patients in the observation group were given early enteral nutrition. Results : Complications of two groups of pulmonary infection, heart failure, digestive tract symptoms and electrolyte disorder, there was no significant difference between the two groups(P>0.05), L/M ratio of the control group and observation group after treatment decreased significantly(P<0.05), among them, L/M ratio of the observation group after treatment was significantly lower than that in control group(P<0.05), indicating that enteral nutrition and intestinal mucosal permeability improved significantly. Conclusion : Early enteral nutrition can improve the nutritional status of the patients, and preserve the integrity and the normal function of the intestinal barrier after cerebral hemorrhage.
Objective : To explore the clinical value of early enteral nutrition in preventing intestinal barrier damage after cerebral hemorrhage. Methods : Nutrition therapy for 240 cases of cerebral hemorrhage patients in the neurosurgical department of our hospital from January 2016 to March 2018 were analyzed and assessed, all patients according to the digital table randomized divided into observation group(n=120) and the control group(n=120). Patients in the control group were given clinical routine parenteral nutrition. The patients in the observation group were given early enteral nutrition. Results : Complications of two groups of pulmonary infection, heart failure, digestive tract symptoms and electrolyte disorder, there was no significant difference between the two groups(P>0.05), L/M ratio of the control group and observation group after treatment decreased significantly(P<0.05), among them, L/M ratio of the observation group after treatment was significantly lower than that in control group(P<0.05), indicating that enteral nutrition and intestinal mucosal permeability improved significantly. Conclusion : Early enteral nutrition can improve the nutritional status of the patients, and preserve the integrity and the normal function of the intestinal barrier after cerebral hemorrhage.
引文
[1]李艳玲.薏苡仁联合肠内营养对脑卒中患者肠屏障功能的影响[D].天津:天津医科大学,2012:33-36.
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[18]张继龙,武国艳,汪连珍,等.急性脑出血大鼠肠屏障功能的变化[J].神经损伤与功能重建,2014,9(2):105-107,118.
[19]秦跃红,张艳丽,张艳艳.重症高血压脑出血术后肠内营养支持的护理[J].全科护理,2015,13(3):250-252.
[20]瓦永禄.早期肠内复方谷氨酰胺在重症急性胰腺炎治疗中的应用疗效[J].世界华人消化杂志,2015,23(9):1484-1488.
[21]王庆华,管清海,陈强谱.早期生态免疫肠内营养对梗阻性黄疸患者术后免疫和肠黏膜屏障的影响[J].中国老年学杂志,2015,35(6):1522-1524.
[2]史树海,程景丽.重症脑卒中患者早期肠内、肠外和个体化营养治疗的对比分析[J].中国现代医生,2015,53(32):93-96.
[3]赵金霞.早期肠内营养预防脑出血术后应激性溃疡的临床研究[J].中西医结合心脑血管病杂志,2015,13(1):121-122.
[4]张东明,李明章,胡江,等.早期小剂量肠内营养在胃癌术后患者中应用的效果评价[J].中国实用医药,2015,10(7):104-105.
[5]刘东玲,余强,王冬华.营养支持在脑卒中患者治疗中的应用进展[J].护理实践与研究,2015,12(2):21-22.
[6]胡世林.早期肠内营养支持在重症急性胰腺炎中的应用[J].中国实用医药,2013,8(32):128-129.
[7]午水东,刘虹.重症患者肠内肠外营养支持治疗疗效分析[J].中外医疗,2015,34(6):78-80.
[8]许建宁.食管癌术后早期肠内营养对患者肠黏膜屏障功能的影响[J].中国社区医师,2014(31):55-55,57.
[9]吕培华.重症急性胰腺炎早期肠内营养预防胃肠功能衰竭[J].实用临床医药杂志,2014,18(21):190-191.
[10]孟庆山,唐东方,李昌盛,等.食管癌术后早期肠内营养的临床应用[J].中国当代医药,2013,20(35):34-35.
[11]姜正荣.脑卒中患者肠内营养胃肠道并发症68例预见性护理干预[J].现代医药卫生,2015,31(5):746-747.
[12]王振疆,陈渝萍.炎症性肠病与肠黏膜屏障关系的研究进展[J].右江医学,2015,43(1):97-101.
[13]郭蕾,潘利伟,范录平,等.肠内和肠外营养支持对于早期重症脑卒中的效果分析[J].中国慢性病预防与控制,2015,23(4):303-304.
[14]胡毅,博涛,高文彪.早期肠内营养支持对重症急性胰腺炎患者炎症反应和免疫功能的影响[J].中国老年学杂志,2015,35(8):2083-2084.
[15]李丽,李红晨,杜建成.早期肠内营养支持对重症脑卒中患者营养和免疫功能的影响[J].肠外与肠内营养,2015,22(2):68-70.
[16]张慧,李涛,江涌.加用益生菌的早期肠内营养治疗高血压脑出血效果评价[J].中国药业,2015,24(11):2-14.
[17]王惠凌,姜源涛,张红,等.重症脑卒中患者肠黏膜屏障功能的变化[J].临床荟萃,2015,30(5):529-532.
[18]张继龙,武国艳,汪连珍,等.急性脑出血大鼠肠屏障功能的变化[J].神经损伤与功能重建,2014,9(2):105-107,118.
[19]秦跃红,张艳丽,张艳艳.重症高血压脑出血术后肠内营养支持的护理[J].全科护理,2015,13(3):250-252.
[20]瓦永禄.早期肠内复方谷氨酰胺在重症急性胰腺炎治疗中的应用疗效[J].世界华人消化杂志,2015,23(9):1484-1488.
[21]王庆华,管清海,陈强谱.早期生态免疫肠内营养对梗阻性黄疸患者术后免疫和肠黏膜屏障的影响[J].中国老年学杂志,2015,35(6):1522-1524.