益生菌对重型颅脑损伤患者肠内营养耐受性的影响

目的:观察益生菌对重型颅脑损伤患者肠内营养耐受性的影响。方法:按随机数字表法将52例重型颅脑损伤患者分别纳入试验组及对照组,每组26例。所有患者入院后均按《颅脑创伤临床救治指南》予以手术、脱水降颅内压、抗感染、抗癫痫、保护胃肠黏膜、营养脑细胞及对症等常规治疗,并于入院后24⁴8 h开始经鼻胃管肠内营养。试验组在此基础上给予益生菌制剂3.5 g/次、3次/d。观察肠内营养过程中患者返流、呕吐、胃潴留、腹胀、腹泻、便秘等发生情况,并记录首次排便及达目标肠内营养量时间。结果:两组患者发生呕吐、胃潴留及腹胀情况无统计学意义(P>0.05),试验组发生返流、腹泻、便秘情况显著少于对照组,首次排便和达目标肠内营养量时间显著早于对照组(P<0.05)。结论:益生菌可促进重型颅脑损伤后胃肠动力恢复,提高患者对肠内营养的耐受性,但其内在机制有待于进一步探讨。

Effects of probiotics on nasogastric feeding intolerance in patients with severe traumatic brain injury

Objective: To investigate the effects of probiotics on nasogastric feeding intolerance in severe traumatic brain-injured patients. Methods: 52 patients with severe traumatic brain injury were randomized into experimental and control group( 26 cases for each). All patients received conventional treatment according to the Guidelines for the Clinical Management of Traumatic Brain Injury and received enteral nutrition via nasogastric tube within 24 ~ 48 h following admission. The experimental group received Golden Bifid3. 5 g per time and 3 times per day in addition. Gastro-oesophageal reflux,vomit,gastric residuals,abdominal distension,diarrhea,constipation,the time to first defecation,as well as the time to targeted nutritional goals with enteral nutrition were recorded. Results: There were no differences between groups in terms of the vomit,gastric residuals and abdominal distension( P > 0. 05). The experimental group developed less cases of gastro-oesophageal reflux,diarrhea,and constipation,and exhibited earlier time to first defecation and to targeted nutritional goals with enteral nutrition compared with the control group( P < 0. 05). Conclusion: Probiotics could improve gastrointestinal motility and nasogastric feeding intolerance in patients with severe brain injury. The underlying mechanisms,however,need to be further investigated.