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目的研究重症监护病房(ICU)重症颅脑损伤患者添加谷氨酰胺肠外营养治疗对临床效果、营养不良-炎症评分(MIS)及肠道黏膜功能的影响。方法选取2015年6月至2016年6月收治ICU重症颅脑损伤66例患者临床资料进行分析,按照临床所用不同治疗方案分成两组,将行单纯肠外营养支持治疗33例患者作为对照组,将添加谷氨酰胺肠外营养治疗33例患者作为观察组,对两组临床效果、MIS评分及治疗后肠道黏膜功能进行对比分析。结果观察组治疗后Ig G、CD4+及CD8+水平均高于治疗前及对照组治疗后,差异有统计学意义(P<0.05,P<0.01);观察组治疗后体质指数、载铁蛋白、血清白蛋白得分及MIS总评分均低于对照组,差异有统计学意义(P均<0.01);观察组治疗后L/M、DAO和IFABP水平均优于对照组(P<0.05)。结论 ICU重症颅脑损伤者添加谷氨酰胺肠外营养治疗能够提高免疫功能,促进患者营养状况改善,且提高患者肠道黏膜的屏障功能。
Objective To study the effects of glutamine parenteral nutrition therapy in intensive care unit (ICU) patients with severe craniocerebral injury on the clinical effects, malnutrition - inflammation score (MIS) and intestinal mucosal function. Methods The clinical data of 66 patients with ICU severe craniocerebral injury who were admitted to our hospital from June 2015 to June 2016 were analyzed and divided into two groups according to the different clinical treatment regimens. 33 patients who underwent simple parenteral nutrition support were selected as the control group, Thirty-three patients with glutamine parenteral nutrition were added as observation group, and the clinical effects, MIS score and intestinal mucosal function were compared between the two groups. Results The levels of Ig G, CD4 + and CD8 + in the observation group after treatment were significantly higher than those before treatment and in the control group (P <0.05, P <0.01). After treatment, the body mass index, Albumin score and MIS total score were lower than the control group, the difference was statistically significant (P <0.01). The levels of L / M, DAO and IFABP in the observation group were better than those in the control group (P <0.05). CONCLUSIONS: Glutamine parenteral nutrition treatment in ICU patients with severe craniocerebral injury can improve the immune function, improve the nutritional status of patients and improve the barrier function of intestinal mucosa in patients.