含合生元的早期肠内营养对严重烧伤病人血浆内毒素的影响

目的:探讨含合生元的早期肠内营养对严重烧伤病人血浆内毒素血症的影响。方法:随机双盲对照临床研究。40例重度烧伤病人分成含合生元(乳酸菌+纤维素)的早期肠内营养组(治疗组)和仅含纤维素的早期肠内营养组(对照组)。治疗前、伤后D3、D7、D10、D14和D21动态测定血内毒素水平。结果:几乎所有时相点治疗组血浆内毒素水平低于对照组,伤后D10有明显差异(P<0.05)且整个研究过程中治疗组内毒素血症发生率明显低于对照组(36.7%vs49.2%,P<0.05)。治疗组感染并发症较对照组也有所下降。结论:含合生元的早期肠内营养可以改善中毒以上烧伤病人内毒素血症的严重程度,对感染并发症产生了积极的影响。

EFFECT OF EARLY ENTERAL NUTRITION WITH SYNBIOTICS ON PLASMA ENDOTOXIN LEVELS IN SERIOUS BURNED PATIENTS

Abjective Object:To investigate the influence of early enteral nutrition with synbiotics on plasma endotoxin levels and the incidence of sepsis complication in severely burned patients. Methods: Randomized double blind study was employed. Forty severely burned patients with burned surface area more than 30% were randomly divided into treatment and control groups with 20 in each . The patients in treatment group received early enteral nutrition with synbiotics including four kinds of lactic acid bacteria and four kinds of fibers,while those in the control group received early enteral nutrition with prebiotics including only four kinds of fibers. The plasma endotoxin level in both groups was dynamically determined on the 1st,3rd,7th,10th,14th and 21st postburn days. Result: On almost all postburn days the plasma endotoxin levels in treatment group were lower than those in control group,especially significant on the postburn day 10 (P<0.05). And also the abnormal rate of plasma endotoxin and the incidence of sepsis complication in treatment group were obviously lower than those in control group (P<0.05). Conclusion: Early enteral nutrition with synbiotics was helpful to the decrease of plasma endotoxin level and this might be beneficial to control of burn infection.