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目的探讨美洲大蠊提取物对早期行肠内营养危重症患者的胃肠道不良反应、营养状况及预后的影响。方法将96例早期行肠内营养的危重症患者随机为治疗组和对照组各48例,对照组给予常规综合治疗,治疗组在常规治疗基础上给予美洲大蠊提取物,经胃管给药,每次10 m L,每日3次,连用7 d。于治疗前和治疗3、7 d后,分别监测超敏C反应蛋白(hs-CRP)、急性生理与慢性健康评分(APACHEⅡ)和营养指标。记录相关胃肠道不良反应(腹胀、腹泻、反流)及死亡率。结果治疗后,两组hsCRP和APACHEⅡ均显著降低,营养指标显著改善(P<0.05,P<0.01)。治疗3 d后,治疗组和对照组hs-CRP为(42.91±23.65)vs.(54.33±24.90)mg·L-1,APACHEⅡ为(14.22±4.13)vs.(15.96±4.08)分,治疗组改善优于对照组(P<0.05)。治疗7 d后,治疗组和对照组总蛋白为(59.07±9.15)vs.(54.68±9.10)g·L-1,前白蛋白为(235.91±61.37)vs.(179.84±55.85)mg·L-1,治疗组营养状况好于对照组(P<0.05,P<0.01)。治疗组消化道不良反应(腹胀、腹泻、反流)发生率明显低于对照组(38%vs.77%,P<0.05)。结论美洲大蠊提取物能降低早期行肠内营养的危重症患者胃肠不良反应,改善营养状况,改善病情及预后。
Objective To investigate the effects of Periplaneta americana extract on gastrointestinal adverse reactions, nutritional status and prognosis in patients with early critical enteral nutrition. Methods A total of 96 cases of critically ill patients enrolled in early enteral nutrition were randomly divided into treatment group (48 cases) and control group (48 cases). The control group was given conventional comprehensive treatment. The treatment group was given routine treatment with American Periplaneta extract, , Each 10 m L, 3 times a day, once every 7 d. The levels of hs-CRP, APACHEⅡ and nutrition were monitored before treatment and after 3 and 7 days of treatment respectively. Record related gastrointestinal adverse reactions (bloating, diarrhea, reflux) and mortality. Results After treatment, the hsCRP and APACHEⅡwere significantly decreased in both groups, and the nutrition indexes were significantly improved (P <0.05, P <0.01). After 3 days of treatment, hs-CRP in the treatment group and control group was (42.91 ± 23.65) vs. (54.33 ± 24.90) mg · L-1, and APACHEⅡ was (14.22 ± 4.13) vs. (15.96 ± 4.08) Improve better than the control group (P <0.05). After 7 days of treatment, the total protein in the treatment group and the control group was (59.07 ± 9.15) vs. (54.68 ± 9.10) g · L -1, prealbumin was (235.91 ± 61.37) vs. (179.84 ± 55.85) mg · L -1. The nutritional status of the treatment group was better than that of the control group (P <0.05, P <0.01). The incidence of gastrointestinal adverse reactions (bloating, diarrhea, reflux) in the treatment group was significantly lower than that in the control group (38% vs 77%, P <0.05). Conclusion Periplaneta americana extract can reduce gastrointestinal adverse reactions in early critically ill patients enrolled in enteral nutrition, improve nutritional status, and improve disease status and prognosis.