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目的:探讨酪酸梭菌活菌胶囊联合早期肠内营养对危重病患者营养状况及胃肠道并发症的影响。方法:ICU住院患者84例随机分为观察组42例和对照组42例。两组患者入院后均早期留置胃管鼻饲行肠内营养支持治疗,予肠内营养混悬液(百普力)恒速灌注,开始为500 ml·d-1,后逐渐加量至1 000~2 000 ml·d-1。观察组患者在此基础上加用酪酸梭菌活菌胶囊0.4 g水化后自胃管注入,tid,连用2周。比较两组患者治疗前后营养状况变化及胃肠道并发症。结果:治疗2周后,两组患者血清白蛋白(Alb)、血红蛋白(Hb)及上臂三头肌肌围(MAMC)水平均较前明显下降(P<0.05或0.01),但观察组下降幅度明显低于对照组(P<0.05);治疗期间,观察组患者胃肠道并发症发生率(7.14%)明显低于对照组(23.81%)(P<0.05)。结论:酪酸梭菌活菌胶囊与早期肠内营养联合应用于危重病患者,可减缓患者营养状况恶化,改善患者胃肠道功能,降低胃肠道并发症发生,疗效明显优于单纯的早期肠内营养治疗。
Objective: To investigate the effects of Clostridium butyricum and early enteral nutrition on nutritional status and gastrointestinal complications in critically ill patients. Methods: Eighty-four ICU inpatients were randomly divided into observation group (42 cases) and control group (42 cases). Both groups were enrolled in the early gastric tube nasal feeding after enteral nutrition support treatment, to the enteral nutrition suspension (Prestare) constant infusion, beginning with 500 ml · d-1, then gradually increase to 1 000 ~ 2000 ml · d-1. On the basis of this observation group patients added Clostridium butyricum viable capsule 0.4 g hydration from the stomach after injection, tid, once every 2 weeks. The changes of nutritional status and gastrointestinal complications before and after treatment were compared between the two groups. Results: After two weeks of treatment, serum Alb, hemoglobin (Hb) and truncus muscle (MAMC) in both groups were significantly lower than before (P <0.05 or 0.01), but the decrease in the observation group (P <0.05). The incidence of gastrointestinal complications (7.14%) in the observation group was significantly lower than that in the control group (23.81%) during the treatment period (P <0.05). Conclusion: Clostridium butyricum and early enteral nutrition can be applied to critically ill patients, which can alleviate the deterioration of nutritional status, improve the function of gastrointestinal tract and reduce the incidence of gastrointestinal complications. The curative effect is better than simple early intestine Internal nutrition treatment.