[1]胡均贤,徐春林.早期肠内营养对重型颅脑损伤患者免疫功能及并发症的影响[J].新乡医学院学报,2016,33(12):1071-1073.[doi:10.7683/xxyxyxb.2016.12.014]
　HU Jun-xian,XU Chun-lin.Effect of early enteral nutrition on immune function and complications in patients with severe craniocerebral injury[J].Journal of Xinxiang Medical University,2016,33(12):1071-1073.[doi:10.7683/xxyxyxb.2016.12.014]
点击复制

早期肠内营养对重型颅脑损伤患者免疫功能及并发症的影响
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年12
页码:
1071-1073
栏目:
临床研究
出版日期:
2016-12-05

文章信息/Info

Title:
Effect of early enteral nutrition on immune function and complications in patients with severe craniocerebral injury
作者:
胡均贤; 徐春林
（黄冈市中心医院神经外科，湖北　黄冈　438000）
Author(s):
HU Jun-xian; XU Chun-lin
(Department of Neurosurgery,Huanggang Central Hospital,Huanggang 438000,Hubei Province,China)
关键词:
早期肠内营养; 重型颅脑损伤; 免疫功能; 并发症
Keywords:
early enteral nutrition; severe craniocerebral injury; immune function; complication
分类号:
R459.3
DOI:
10.7683/xxyxyxb.2016.12.014
文献标志码:
A
摘要:
目的　探讨早期肠内营养对重型颅脑损伤患者免疫功能及并发症的影响。方法　选取2013年8月至2015年8月黄冈市中心医院收治的重型颅脑损伤患者100例，其中50例患者给予早期肠外营养支持（对照组），50例患者于伤后12 h给予早期肠内营养（观察组）；观察并比较2组患者的免疫功能及并发症发生情况。结果　治疗前2组患者血浆IgM、IgG、IgA和IgE水平比较差异均无统计学意义（P>0.05）。对照组患者治疗1周后血浆IgM、IgG、IgA水平显著低于治疗前（P<0.05），IgE水平显著高于治疗前（P<0.05）。观察组患者治疗1周后血浆IgM、IgG水平显著低于治疗前（P<0.05），但治疗前后血浆IgA、IgE水平比较差异无统计学意义（P>0.05）。治疗1周后，观察组患者血浆中IgM、IgG、IgA水平显著高于对照组（P<0.05），IgE水平显著低于对照组（P<0.05）。治疗前2组患者血浆中CD4+、CD8+水平、CD4+/CD8+比较差异均无统计学意义（P>0.05）。治疗1周后，2组患者CD4+水平、CD4+/CD8+显著高于治疗前（P<0.01），观察组患者CD4+水平、CD4+ /CD8+显著高于对照组（P<0.05）。观察组和对照组患者并发症发生率分别为12.0%（6/50）和38.0%（19/50），观察组患者并发症发生率显著低于对照组（P<0.05）。结论　早期肠内营养可显著改善重型颅脑损伤患者的免疫功能，降低并发症发生率。
Abstract:
Objective　To investigate the effect of early enteral nutrition on immune function and complications in patients with severe craniocerebral injury.Methods　A total of 100 patients with severe craniocerebral injury in Huanggang Central Hospital were selected from August 2013 to August 2015.Among the patients,50 patients in control group were treated with early parenteral nutrition,the other 50 patients in observation group were treated with early enteral nutritional.The immune function and complication incidence were compared between the two groups.Results　There was no significant difference in the levels of plasma IgE,IgG,IgA and IgM between the two groups before treatment(P>0.05).The levels of plasma IgM,IgG and IgA after one week treatment were significantly lower than those before treatment(P<0.05),and the level of plasma IgE after one week treatment was significantly higher than that before treatment in control group(P<0.05).The levels of plasma IgG and IgM after one week treatment were significantly lower than those before treatment(P<0.05),but there was no significant difference in the levels of plasma IgA and IgE before and after treatment in the observation group(P>0.05).One week after treatment,the levels of plasma IgM,IgG and IgA in observation group were significantly higher than those in control group(P<0.05),and the level of IgE in observation group was significantly lower than that in control group(P<0.05).There was no significant difference in plasma CD4+,CD8+ levels and CD4+/CD8+ between the two groups before treatment(P>0.05).The CD4+ level and CD4+/CD8+ after one week treatment was significantly higher than that before treatment in the two groups(P<0.01),and the CD4+ level and CD4+/CD8+ in observation group were significantly higher than those in control group(P<0.05).The incidence of complications in observation group and control group was 12.0%(6/50)and 38.0%(19/50)respectively,the incidence of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion　Early enteral nutrition can significantly improve the immune function,and reduce the incidence of complications in patients with severe craniocerebral injury.

参考文献/References:

［1］　吴鸣，吴有志，罗良生.营养支持对重型颅脑损伤病人营养指标和肺部感染的影响［J］.肠外与肠内营养，2012，19（2）：80-82.
［2］　CLIFTON G L,VALADKA A,ZYGUN D,et al.Very early hypothermia induction in patients with severe brain injury(the national acute brain injury study:hypothermia II):a randomised trial［J］.Lancet Neurol,2011,10(2):131-139.
［3］　孙鹏，李双成，陈凌志.重型颅脑损伤患者术后不同营养方式对颅内感染影响的研究［J］.中华医院感染学杂志，2014，24（1）：173-175.
［4］　龚四堂.肠内营养技术在儿科中的应用［J］.中华实用儿科临床杂志，2014，29（7）：481-483.
［5］　徐慧玲.肠内营养与肠外营养支持对重型颅脑损伤患者手术预后的影响［J］.中国实用神经疾病杂志，2015，18（9）：86-87.
［6］　刘睿，于东.重型颅脑损伤预后相关因素分析及营养支持治疗时机对术后感染的预防效果［J］.重庆医学，2014，43（36）：4945-4947.
［7］　林兴建，龚大伟，陈道文，等.早期肠内营养支持治疗对重症脑出血病人预后和营养指标的影响［J］.肠外与肠内营养，2012，19（2）：92-94.
［8］　陈露萍，刘维群，程军.早期肠内营养联合益生菌对重型颅脑损伤患者术后感染的影响研究［J］.中华医院感染学杂志，2015，25（6）：1357-1359.
［9］　张锋，孟兆朋.重型颅脑创伤患者早期肠内营养支持治疗的临床观察［J］.中国现代神经疾病杂志，2014，14（4）：350-352.
［10］　谢浩芬，蔺志清，周圣军，等.肠内营养支持时机对重型颅脑损伤病人术后并发感染的影响［J］.肠外与肠内营养，2011，18（1）：9-11.

相似文献/References:

[1]李浩,靳怀明,李志华.老年人重型颅脑损伤后应激性溃疡72例分析[J].新乡医学院学报,2001,18(05):356.
[2]金保哲,张新中,周国胜.重型颅脑损伤开颅术中急性脑膨出63例临床分析[J].新乡医学院学报,2007,24(05):522.
[3]路德荣,张帮杰,顾世玉,等.早期肠内营养联合清胰汤肠内滴注治疗急性重症胰腺炎疗效观察[J].新乡医学院学报,2012,29(07):535.
[4]徐跃.重型颅脑损伤患者气管插管时机探讨[J].新乡医学院学报,2012,29(01):000.
[5]孟庆军,孟　磊,金保哲,等.依达拉奉联合亚低温治疗重型颅脑损伤临床疗效分析[J].新乡医学院学报,2016,33(11):963.[doi:10.7683/xxyxyxb.2016.11.007]
　MENG Qing-jun,MENG Lei,JIN Bao-zhe,et al.Curative effect of edaravone combined with mild hypothermia in treatment of severe craniocerebral injury[J].Journal of Xinxiang Medical University,2016,33(12):963.[doi:10.7683/xxyxyxb.2016.11.007]

更新日期/Last Update: 2016-12-05