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目的探讨双歧三联活菌胶囊联合早期肠内营养保护呼吸科危重病患者肠黏膜屏障功能作用。方法选取68例呼吸科危重病患者,随机分为联合组和对照组各34例。两组患者均予以留置胃管鼻饲行早期肠内营养。联合组患者在此基础上加用双歧三联活菌肠溶胶囊630mg研磨水化后自留置鼻饲管内注入,3次/d,连用14d。判断并比较两组患者治疗前和治疗14d后营养指标及肠黏膜屏障指标的变化。结果治疗14d后,两组患者白蛋白(ALB)、淋巴细胞总数(LYM)和三头肌皮褶厚度(TSF)指标均较前明显下降(t=2.17、2.24、2.39、2.91、3.03、3.42,P<0.05或P<0.01),且联合组的下降幅度明显低于对照组(t=2.15、2.24、2.22,P<0.05);同时两组患者血清二胺氧化酶(DAO)和D-乳酸指标较前均明显下降(t=2.97、3.43、2.26、2.38,P<0.05或P<0.01),且联合组的下降值较对照组更明显(t=2.19、2.31,P<0.05)。结论双歧三联活菌胶囊联合早期肠内营养可减轻或纠正呼吸科危重病患者的负氮平衡,减缓其营养状况恶化;并可下调血清DAO和D-乳酸指标,保护与改善其肠黏膜屏障功能,加快患者康复。
Objective To investigate the intestinal mucosal barrier function of bifid triple viable capsule combined with early enteral nutrition to protect critically ill patients with respiratory diseases. Methods 68 cases of critically ill respiratory patients were randomly divided into the combined group and the control group of 34 cases. Two groups of patients were left gastric tube nasogastric feeding early enteral nutrition. Combined group of patients on the basis of the use of bifid triple ternary enteric-coated capsules 630mg after hydration from the nasal feeding tube, 3 times / d, once every 14d. The changes of nutrition indexes and intestinal mucosal barrier indexes before treatment and after 14 days of treatment were judged and compared between the two groups. Results After 14 days of treatment, the albumin (ALB), total lymphocyte count (LYM) and triceps skin fold thickness (TSF) were significantly decreased in both groups (t = 2.17,2.24,2.39,2.91,3.03,3.42 , P <0.05 or P <0.01), and the decrease of the combination group was significantly lower than that of the control group (t = 2.15,2.24,2.22, P <0.05); At the same time, the serum diamine oxidase (DAO) Lactic acid index decreased significantly compared with the previous (t = 2.97,3.43,2.26,2.38, P <0.05 or P <0.01), and the combination group decreased more significantly than the control group (t = 2.19,2.31, P <0.05). Conclusions Bifid triple viable capsule combined with early enteral nutrition can reduce or correct negative nitrogen balance in critically ill patients with respiratory diseases and slow down the deterioration of nutritional status. It can also decrease the serum DAO and D-lactic acid indexes to protect and improve the intestinal mucosal barrier Function, speed up patient rehabilitation.