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双歧三联活菌胶囊联合早期肠内营养辅助治疗重型颅脑损伤观察

Observation of Bifid Triple Viable Capsules Combined with Early Enteral Nutrition Adjuvant Therapy of Patients with Severe Head Injury

DOI：

中文关键词: 重型颅脑损伤早期肠内营养双歧三联活菌胶囊营养状况细胞免疫

英文关键词:Severe head injury Early enteral nutrition Bifid triple viable capsules Nutrition state Cellular immune

基金项目:

作者	单位
周少军	衢州市衢江区人民医院重症监护室（浙江衢州 324000）

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中文摘要:

摘要目的:观察双歧三联活菌胶囊联合早期肠内营养辅助治疗对重型颅脑损伤(SHI)患者营养状况及细胞免疫功能的影响。方法：闭合性SHI住院患者70例随机分为观察组和对照组，每组35例。两组均予降颅内压、血压及血糖，营养及保护脑细胞，预防感染、保护胃黏膜和维持水电解质酸碱平衡等基础治疗。对照组给予早期留置胃管鼻饲行肠内营养治疗，观察组在对照组基础上加用双歧三联活菌胶囊630 mg研磨水化后自胃管注入，tid，连用15 d。比较两组患者治疗前后营养状况、格拉斯哥(GCS)评分及细胞免疫功能的变化。结果：治疗后，两组总蛋白(TP)、白蛋白(Alb)水平较前不同程度下降，GCS 评分较前明显上升(P<0.05或P<0.01)，且观察组TP和Alb水平下降幅度明显低于对照组，GCS 评分上升幅度明显高于对照组（P＜0.05）。两组血清CD4⁺水平和CD4⁺/CD8⁺比值较前明显上升(P<0.05或P<0.01)，且观察组上升幅度较对照组更明显（P＜0.05），而两组治疗前后CD8⁺水平无明显变化（P＞0.05）。结论：双歧三联活菌胶囊联合早期肠内营养辅助治疗SHI患者的疗效确切，可明显减缓和改善SHI患者的营养状况恶化，提高其GCS 评分，并能提高患者CD4⁺水平和CD4⁺/CD8⁺比值，增强其细胞免疫功能。

英文摘要:

ABSTRACT Objective:To observe the influence of bifid triple viable capsules combined with early enteral nutrition adjuvant therapy on cellular immune function of patients with severe head injury (SHI). Methods:70 cases of patients with closed SHI, who were given medical treatment in hospital, were divided into observation group and control group at random,with 35 cases of patients in either group. The patients in two groups were given basic medical treatment, such like lowering intracranial pressure, blood pressure and blood sugar, brain cells nutrition and protection, antibiotics to prevent infection, protection of gastric mucosa, maintenance of water electrolyte and acid base balance and etc, and the patients in control group were given early gastric tube indwelling nasogastric enteral nutrition, while the patients in combined group were additionally given 630mg bifid triple viable capsules, which were ground, hydrated and injected by stomach tube, three times a day, for 15 days. The changes of nutrition state, GCS and cellular immune function of patients in two groups before and after medical treatment were observed and recorded. Results:After 15 days' medical treatment, total protein (TP) and albumin (Alb) levels of patients in two groups declined than before with different degrees, while GCS obviously rose than before (P<0.05 or P<0.01), and the declining rates of TP and Alb levels in observation group were much lower than those in control group, and the rising rate of GCS of patients in observation group was much higher than that in control group （P＜0.05）. Meanwhile, serum CD4+ levels and CD4+/CD8+ ratios of patients in two groups obviously rose than before (P<0.05 or P<0.01), and the rising rate of patients in observation group was much higher than that in control group （P＜0.05）, while the CD8+ levels of patients in two groups showed no obvious changes before and after medical treatment. 〖WTHZ〗Conclusion: 〖WTBZ〗Bifid triple viable capsules combined with early enteral nutrition adjuvant therapy had favorable curative effect on patients with SHI, which could obviously release and improve the depravation of nutrition state of patients with SHI, improve GCS, raise CD4+ level and CD4+/CD8+ ratio and enhance cellular immune function.

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