早期肠内营养对重型颅脑损伤患者免疫功能及并发症的影响

发布时间：2018-06-09 11:08

本文选题：早期肠内营养 + 重型颅脑损伤　；参考：《新乡医学院学报》2016年12期

【摘要】：目的探讨早期肠内营养对重型颅脑损伤患者免疫功能及并发症的影响。方法选取2013年8月至2015年8月黄冈市中心医院收治的重型颅脑损伤患者100例,其中50例患者给予早期肠外营养支持(对照组),50例患者于伤后12 h给予早期肠内营养(观察组);观察并比较2组患者的免疫功能及并发症发生情况。结果治疗前2组患者血浆IgM、IgG、IgA和IgE水平比较差异均无统计学意义(P0.05)。对照组患者治疗1周后血浆IgM、IgG、IgA水平显著低于治疗前(P0.05),IgE水平显著高于治疗前(P0.05)。观察组患者治疗1周后血浆IgM、IgG水平显著低于治疗前(P0.05),但治疗前后血浆IgA、IgE水平比较差异无统计学意义(P0.05)。治疗1周后,观察组患者血浆中IgM、IgG、IgA水平显著高于对照组(P0.05),IgE水平显著低于对照组(P0.05)。治疗前2组患者血浆中CD4~+、CD8~+水平、CD4~+/CD8~+比较差异均无统计学意义(P0.05)。治疗1周后,2组患者CD4~+水平、CD4~+/CD8~+显著高于治疗前(P0.01),观察组患者CD4~+水平、CD4~+/CD8~+显著高于对照组(P0.05)。观察组和对照组患者并发症发生率分别为12.0%(6/50)和38.0%(19/50),观察组患者并发症发生率显著低于对照组(P0.05)。结论早期肠内营养可显著改善重型颅脑损伤患者的免疫功能,降低并发症发生率。
[Abstract]:Objective to investigate the effect of early enteral nutrition on immune function and complications in patients with severe craniocerebral injury. Methods from August 2013 to August 2015, 100 patients with severe craniocerebral injury were treated in Huanggang Central Hospital. 50 patients were treated with early parenteral nutrition (control group, 50 patients received early enteral nutrition 12 hours after injury), and the immune function and complications of the two groups were observed and compared. Results there was no significant difference in the levels of IgA and IgE between the two groups before treatment (P 0.05). After 1 week of treatment, the level of IgA in the control group was significantly lower than that in the control group (P 0.05), and the level of IgE in the control group was significantly higher than that in the control group (P 0.05). After 1 week treatment, the level of IgMN IgG in the observation group was significantly lower than that in the control group (P 0.05), but there was no significant difference between the two groups before and after treatment (P 0.05). After one week of treatment, the level of IgA in plasma of the patients in the observation group was significantly higher than that in the control group (P 0.05) and the level of IgE in the control group was significantly lower than that in the control group (P 0.05). There was no significant difference in plasma levels of CD4 ~ + / CD8- / CD8 ~ between the two groups before treatment (P 0.05). One week after treatment, the levels of CD4 ~ / CD8 ~ in the two groups were significantly higher than those in the control group (P 0.01), and the levels of CD _ 4 ~ / CD _ 8 ~ in the observation group were significantly higher than those in the control group (P 0.05). The incidence of complications in the observation group and the control group were 12.0 / 50 and 38.0 / 50 respectively. The incidence of complications in the observation group was significantly lower than that in the control group (P 0.05). Conclusion early enteral nutrition can significantly improve the immune function and reduce the incidence of complications in patients with severe craniocerebral injury.
【作者单位】：黄冈市中心医院神经外科;
【分类号】：R651.15

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