早期肠内营养改善创伤性肠破裂修补术后营养状况和免疫功能效果分析

目的探讨早期肠内营养对创伤性肠破裂修补术后患者的营养状况和免疫功能的影响。方法选择2013年3月~2015年3月收治的51例创伤性肠破裂修补术后患者,随机分为对照组25例,观察组26例。所有患者均采取肠外营养(PN),观察组患者增加早期肠内营养(EEN),比较两组患者住院时间和术后并发症发生率,术前和术后7d白蛋白(ALB)、前清蛋白(PA)及免疫细胞和免疫球蛋白浓度。结果观察组患者住院时间显著少于对照组(P0.05),两组患者术后并发症发生率差异无统计学意义(P0.05),术后7d观察组患者白蛋白(ALB)和前清蛋白(PA)浓度均高于同期对照组,且差异有统计学意义(P0.05);观察组T淋巴细胞中CD4~+、CD4~+/CD8~+和免疫球蛋白(lg M)与同期对照组相比,差异有统计学意义(P0.05)。结论早期肠内营养在改善创伤性肠破裂患者修补术后的营养状况和免疫功能中具有明显效果,值得临床推广与应用。

Analysis of nutritional status and immune function of early enteral nutrition in the repair of traumatic rupture of intestine

Objective To investigate nutritional status and immune function of early enteral nutrition in the repair of traumatic rupture of intestine.Methods Fifty-one patients with traumatic rupture of intestine who were admitted into our hospital from Mar.2013 to Mar.2015 were randomized to observation group ( n=26 ) and control group (n=25) respectively.Parenteral nutrition (PN) was provided to all patients, and early enteral nutrition ( EEN) was provided additionally in the observation group.The length of hospital stay, incidence rate of postopera-tive complications, preoperative and postoperative concentration of albumin (ALB), prealbumin (PA), immune cell and immunoglobulin were compared between the two groups.Results The length of hospital stay of the obser-vation group was significantly shorter than the control group (P<0.05), and there was no significant difference in the incidence rate of complications between the two groups(P>0.05).The concentration of albumin and prealbumin (PA) of the observation group was significantly higher than the control group 7 d after surgery(P<0.05).There was statistical difference in CD4+, CD4+/CD8+and lgM between the two groups(P<0.05).Conclusion Compared with PN, nutritional status and immune function of EEN in the repair of traumatic rupture of intestine is better, and it is worthy of clinical popularization and application.