不同时机肠内营养支持对重症颅脑损伤患者胃肠屏障功能、炎性应激状态的影响

目的探讨不同时机肠内营养支持对重症颅脑损伤患者胃肠屏障功能、炎性应激状态的影响。方法选取2018年5月至2020年8月收治的65例重症颅脑损伤患者,以随机数字表法将其分为观察组(n=33)和对照组(n=32)。观察组行早期肠内营养支持(术后24 h内),对照组行延迟肠内营养支持(术后24~72 h),均鼻饲2周。比较两组患者干预前、后胃肠屏障功能、炎性应激状态及营养状态。结果干预后,两组的IFABP、D-乳酸、DAO、IL-6、PCT、GLU水平及NEU均较干预前显著降低,且观察组低于对照组(P<0.05)。干预后,两组的Hb、ALB及PA水平均较干预前升高,且观察组高于对照组(P<0.05)。结论早期给予重症颅脑损伤患者肠内营养支持可改善其营养状态,有效修复肠黏膜损伤,改善胃肠屏障功能,减轻炎症应激状态。

Effects of enteral nutrition support at different time on gastrointestinal barrier function and inflammatory stress state in patients with severe craniocerebral injury

Objective To explore the effects of enteral nutrition support at different time on gastrointestinal barrier function and inflammatory stress state in patients with severe craniocerebral injury.Methods Sixty-five patients with severe craniocerebral injury admitted from May 2018 to August 2020 were selected and divided into observation group(n=33)and control group(n=32)according to random number table method.The observation group was given early enteral nutrition support(within 24 h after operation),the control group was given delayed enteral nutrition support(24-72 h after operation),and all patients were given nasal feeding for 2 weeks.The gastrointestinal barrier function,inflammatory stress and nutritional status of the two groups were compared before and after intervention.Results After intervention,the levels of IFABP,D-lactic acid,DAO,IL-6,PCT,GLU and NEU in the two groups were significantly lower than those before intervention,and those of the observation group were lower than the control group(P<0.05).After intervention,the levels of Hb,ALB and PA in the two groups were higher than those before intervention,and those of the observation group were higher than the control group(P<0.05).Conclusion Early enteral nutrition support for patients with severe craniocerebral injury can improve nutritional status,effectively repair intestinal mucosal injury,ameliorate gastrointestinal barrier function,and reduce inflammatory stress status.