摘要
背景老年重症慢性阻塞性肺部疾病急性加重期(acute exacerbation of severe chronic obstructive pulmonary disease,AECOPD)患者,由于年龄和身体的原因,时常发生营养不良,影响病情的转归,需要给予较高质量的肠内营养支持,但是极易发生腹泻、腹胀等不良反应,提高患者肠内营养耐受性成为解决问题的必要途径.目的探讨可溶性膳食纤维(soluble dietary fiber,SDF)+合生元对老年重症AECOPD肠内营养患者营养和耐受性及肠屏障功能影响.方法随机数字表法将2020-01/2022-10我院收治的208例老年重症AECOPD患者分为4组,各52例.常规组给予常规肠内营养,在此基础上,SDF组添加SDF,合生元组添加合生元,联合组添加SDF+合生元.比较各组营养支持前、第8 d、第15 d营养状态[血清总蛋白(total protein,TP)、血红蛋白(hemoglobin,HGB)、前白蛋白(prealbumin,PA)、白蛋白(albumin,ALB)]、目标能量达标时间、机械通气时间、ICU住院时间、总住院时间、血糖水平、胰岛素用量、肠屏障功能[二胺氧化酶(diamine oxidase,DAO)、内毒素、D-乳酸]、免疫功能[CD4^(+)/CD8^(+)、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白M(immunoglobulin M,IgM)、免疫球蛋白G(immunoglobulin G,IgG)]、不良反应、耐受性、感染及生存率.结果SDF组、合生元组、联合组第8 d、第15 d的TP、HGB、PA、ALB均高于常规组,且联合组高于SDF组、合生元组(P<0.05);SDF组、合生元组、联合组目标能量达标时间、机械通气时间、ICU住院时间、总住院时间短于常规组,且联合组短于SDF组、合生元组(P<0.05);SDF组、合生元组、联合组第8 d、第15 d的血糖水平、胰岛素用量均低于常规组,且联合组低于SDF组、合生元组(P<0.05);SDF组、合生元组、联合组第8 d、第15 d的DAO、内毒素、D-乳酸均低于常规组,且联合组低于SDF组、合生元组(P<0.05);合生元组、联合组第8 d、第15 d的CD4^(+)/CD8^(+)、IgA、IgM、IgG均高于常�
BACKGROUND Due to age and physical reasons,elderly patients with severe acute exacerbation of severe chronic obstructive pulmonary disease(AECOPD)often suffer from malnutrition,which affects the outcome of the disease,and need to be given high-quality enteral nutrition support,but they tend to suffer from diarrhea,abdominal distension,and other adverse reactions.Improving patients’tolerance of enteral nutrition has become a necessary way to solve the problem.AIM To investigate the effects of soluble dietary fiber(SDF)plus synbiotics on nutrition status,tolerance of enteral nutrition,and intestinal barrier function in elderly patients with AECOPD on enteral nutrition.METHODS The random number table method was used to divide 208 elderly patients with severe AECOPD admitted to our hospital from January 2020 to October 2022 into four groups of 52 cases each:Conventional group,SDF group,biostime group,and SDF+biostime group.All the groups was given conventional enteral nutrition.Additionally,SDF,biostime,and SDF+biostime were given in the SDF group,biostime group,and SDF+biostime group,respectively.The groups were compared for nutritional status[total serum protein(TP),hemoglobin(HGB),prealbumin(PA),and albumin(ALB)]before nutritional support and on the 8th and 15th days,time to target energy attainment,duration of mechanical ventilation,length of stay in ICU,total length of hospital stay,blood glucose level,insulin dosage,intestinal barrier function[diamine oxidase(DAO),endotoxin,and D-lactic acid],immune function[CD4+/CD8+ratio,immunoglobulin A(IgA),immunoglobulin M(IgM),and immunoglobulin G(IgG)],adverse reactions,tolerance of RESULTS TP,HGB,PA,and ALB were significantly higher in the SDF group,biostime group,and combination group than in the conventional group on the 8th and 15th days,and in the combination group than in the SDF group and biostime group(P<0.05).Time to target energy attainment,mechanical ventilation time,ICU stay time,and total hospital stay time were significantly shorter in the SDF group,biost
作者
杨勤
蔡惠芳
钟丹
Qin Yang;Hui-Fang Cai;Dan Zhong(Department of Critical Care Medicine,Longyou People’s Hospital,Quzhou 324400,Zhejiang Province,China)
出处
《世界华人消化杂志》
CAS
2024年第6期438-446,共9页
World Chinese Journal of Digestology
