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目的探讨微生物免疫肠内营养支持对重度颅脑损伤患者术后效果的影响,进而对临床应用提供指导。方法抽取2011年1月-2014年9月在新疆医科大学第一附属医院外科ICU住院治疗的重症颅脑损伤患者120例作为研究对象,对120例患者在手术后采取4种不同的肠内营养支持方案,比较4种肠内营养支持下患者的各项指标及感染等并发症发生情况。结果 4组患者临床总有效率差异有统计学意义(χ~2=8.045,P=0.045);4组患者的继发感染、胃肠道反应发生率差异有统计学意义(P<0.05),4组患者的脓毒血症、MODS、SIRS以及术后30 d死亡率的发生率差异无统计学意义(P>0.05);4组患者GCS术后15 d评分差异有统计学意义(P<0.05);手术前、术后1、3、7 d的GCS评分差异均无统计学意义(P>0.05);Logistic回归分析结果显示,肠内营养方式、并发症是影响患者临床疗效的独立因素(P<0.05)。结论 24 h对重度颅脑损伤患者使用微生物免疫肠内营养方式有利于患者的治疗、康复,应在临床上加以推广应用。
Objective To investigate the effect of enteral nutrition support by microbe on the postoperative effect of patients with severe craniocerebral injury and to provide guidance for clinical application. Methods A total of 120 severe craniocerebral injury patients hospitalized in surgical ICU of the First Affiliated Hospital of Xinjiang Medical University from January 2011 to September 2014 were selected as the research object. 120 patients underwent four different enteral nutrition Support programs to compare the four indicators of patients with enteral nutrition support and complications such as infection. Results There was significant difference in the total effective rate between the 4 groups (χ ~ 2 = 8.045, P = 0.045). The incidences of secondary infection and gastrointestinal reaction in the 4 groups were statistically significant (P <0.05) There was no significant difference in sepsis, MODS, SIRS and postoperative 30-day mortality between the 4 groups (P> 0.05). There was significant difference in scores of 15-day GCS between the 4 groups (P < 0.05). There was no significant difference in GCS score between preoperative and postoperative 1, 3 and 7 days (P> 0.05). Logistic regression analysis showed that enteral nutrition and complications were independent factors affecting clinical efficacy (P <0.05). Conclusion 24 h treatment of severe craniocerebral injury patients with microbial enteral nutrition in favor of the treatment of patients, rehabilitation, should be popularized in clinical application.