营养管理对腹腔感染患者肠道屏障功能及免疫功能的保护作用研究
本文选题:腹腔感染 切入点:营养管理 出处:《中华医院感染学杂志》2017年09期 论文类型:期刊论文
【摘要】:目的探讨营养支持管理方案在腹腔感染(IAI)患者中对肠道黏膜屏障及免疫功能的保护作用。方法前瞻性收集2015年2月-2016年10月医院收治的IAI患者111例,分为研究组55例和对照组56例;研究组给予标准营养支持管理方案,对照组给予经验性营养支持,比较两组患者一般临床资料及营养指标、肠道屏障指标、炎症指标、免疫指标和临床预后的差异。结果两组患者入院时一般临床资料比较差异无统计学意义;研究组自第7天起血清白蛋白水平、血清前白蛋白水平、血清TNF-α水平、血清内毒素水平、血清IgA及IgG水平与对照组相比,差异均有统计学意义(P0.05);第14天,研究组血清CRP水平显著性低于对照组(t=4.147;P=0.000);第3天起研究组血清D-乳酸水平显著性低于对照组(P0.05);研究组住院时间显著低于对照组,差异有统计学意义(P0.05),但两组病死率未见明显统计学差异。结论营养管理可以有效地维持IAI患者营养状态,降低机体炎症因子水平,保护肠道黏膜屏障功能,改善机体免疫功能,从而改善患者预后。
[Abstract]:Objective to investigate the protective effect of nutritional support management on intestinal mucosal barrier and immune function in patients with intraperitoneal infection. Methods 111 patients with IAI admitted in our hospital from February 2015 to October 2016 were collected prospectively. There were 55 cases in the study group and 56 cases in the control group, the study group was given the standard nutritional support management scheme, and the control group was given the experiential nutritional support. The general clinical data and nutritional index, intestinal barrier index, inflammatory index were compared between the two groups. Results there was no significant difference in the general clinical data between the two groups at admission, the serum albumin level, the serum prealbumin level, the serum TNF- 伪 level from the 7th day in the study group. The levels of serum endotoxin, serum IgA and IgG were significantly different from those of the control group (P 0.05). The serum CRP level in the study group was significantly lower than that in the control group (4.147), the serum D-lactic acid level in the study group was significantly lower than that in the control group (P 0.05) from the 3rd day, and the hospital stay in the study group was significantly lower than that in the control group. The difference was statistically significant (P 0.05), but there was no significant difference in mortality between the two groups. Conclusion Nutrition management can effectively maintain the nutritional status of IAI patients, reduce the level of inflammatory factors, protect the intestinal mucosal barrier function, and improve the immune function of the body. So as to improve the prognosis of patients.
【作者单位】: 嘉兴市第三医院消化内科;嘉兴市第三医院ICU;嘉兴市第三医院急诊科;
【基金】:浙江省医药卫生一般研究计划基金资助项目(2015KYB353)
【分类号】:R57
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