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目的探讨魔芋甘露低聚糖(konjak mannanoligosaccharides,KMOS)肠内营养对重型颅脑损伤病人术后免疫功能的改善作用。方法将78例重型颅脑损伤病人随机分为KMOS组和对照组。KMOS组40例病人采用添加了KMOS的肠内营养制剂均营素匀浆膳经鼻胃管管饲;对照组38例病人肠内营养制剂仅采用均营素匀浆膳。比较两组病人术后第1天、第7天和第14天免疫指标及肠内营养相关并发症发生率的差异。结果 KMOS组腹泻发生率显著低于对照组(P<0.05);两组病人术后第1天免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)和免疫球蛋白M(immunoglobulin M,IgM)的水平无统计学差异(P>0.05),总T淋巴细胞(CD3~+)、辅助T淋巴细胞(CD4~+)、细胞毒性T淋巴细胞(CD8~+)水平和CD4~+/CD8~+比值均无统计学差异(P>0.05);术后第7天KMOS组IgM水平和CD4~+水平显著高于对照组(P<0.05);术后第14天KMOS组IgA、IgG和IgM水平显著高于对照组(P<0.05),CD3~+、CD4~+水平和CD4~+/CD8~+比值均显著高于对照组(P<0.05)。结论在肠内营养制剂中添加KMOS可改善重症颅脑损伤病人免疫功能,降低肠内营养相关腹泻的发生率。
Objective To investigate the effect of konjak mannanoligosaccharides (KMOS) enteral nutrition on postoperative immune function in patients with severe craniocerebral injury. Methods 78 cases of severe traumatic brain injury were randomly divided into KMOS group and control group. Forty KM patients in the KMOS group were given enteral nutrition supplemented with KMOS and were given nasogastric tube feeding. In the control group, 38 patients enrolled in the enteral nutrition were treated with homogenized homogenate alone. The differences of the immune indexes and the incidence of enteral nutrition-related complications on the first, seventh and fourteenth days after operation between the two groups were compared. Results The incidence of diarrhea in KMOS group was significantly lower than that in control group (P <0.05). On the first postoperative day, immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin G There was no significant difference in the level of M (immunoglobulin M, IgM) between the two groups (P> 0.05), total T lymphocyte (CD3 ~ +), T helper lymphocyte (CD4 ~ +), cytotoxic T lymphocyte (CD8 ~ (P> 0.05). The level of IgM and the level of CD4 ~ + in KMOS group on the 7th day after operation were significantly higher than those in the control group (P <0.05). On the 14th day The levels of IgA, IgG and IgM in KMOS group were significantly higher than those in control group (P <0.05). The ratios of CD3 +, CD4 + and CD4 + / CD8 + were significantly higher in KMOS group than those in control group (P <0.05). Conclusion Adding KMOS to enteral nutrition can improve the immune function of patients with severe craniocerebral injury and reduce the incidence of enteral nutrition-related diarrhea.