本文選題：腹腔感染　切入點(diǎn)：營(yíng)養(yǎng)管理　出處：《中華醫(yī)院感染學(xué)雜志》2017年09期 　論文類(lèi)型：期刊論文

【摘要】：目的探討營(yíng)養(yǎng)支持管理方案在腹腔感染(IAI)患者中對(duì)腸道黏膜屏障及免疫功能的保護(hù)作用。方法前瞻性收集2015年2月-2016年10月醫(yī)院收治的IAI患者111例,分為研究組55例和對(duì)照組56例;研究組給予標(biāo)準(zhǔn)營(yíng)養(yǎng)支持管理方案,對(duì)照組給予經(jīng)驗(yàn)性營(yíng)養(yǎng)支持,比較兩組患者一般臨床資料及營(yíng)養(yǎng)指標(biāo)、腸道屏障指標(biāo)、炎癥指標(biāo)、免疫指標(biāo)和臨床預(yù)后的差異。結(jié)果兩組患者入院時(shí)一般臨床資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義;研究組自第7天起血清白蛋白水平、血清前白蛋白水平、血清TNF-α水平、血清內(nèi)毒素水平、血清IgA及IgG水平與對(duì)照組相比,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);第14天,研究組血清CRP水平顯著性低于對(duì)照組(t=4.147;P=0.000);第3天起研究組血清D-乳酸水平顯著性低于對(duì)照組(P0.05);研究組住院時(shí)間顯著低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但兩組病死率未見(jiàn)明顯統(tǒng)計(jì)學(xué)差異。結(jié)論營(yíng)養(yǎng)管理可以有效地維持IAI患者營(yíng)養(yǎng)狀態(tài),降低機(jī)體炎癥因子水平,保護(hù)腸道黏膜屏障功能,改善機(jī)體免疫功能,從而改善患者預(yù)后。
[Abstract]:Objective to investigate the protective effect of nutritional support management on intestinal mucosal barrier and immune function in patients with intraperitoneal infection. Methods 111 patients with IAI admitted in our hospital from February 2015 to October 2016 were collected prospectively. There were 55 cases in the study group and 56 cases in the control group, the study group was given the standard nutritional support management scheme, and the control group was given the experiential nutritional support. The general clinical data and nutritional index, intestinal barrier index, inflammatory index were compared between the two groups. Results there was no significant difference in the general clinical data between the two groups at admission, the serum albumin level, the serum prealbumin level, the serum TNF- 偽 level from the 7th day in the study group. The levels of serum endotoxin, serum IgA and IgG were significantly different from those of the control group (P 0.05). The serum CRP level in the study group was significantly lower than that in the control group (4.147), the serum D-lactic acid level in the study group was significantly lower than that in the control group (P 0.05) from the 3rd day, and the hospital stay in the study group was significantly lower than that in the control group. The difference was statistically significant (P 0.05), but there was no significant difference in mortality between the two groups. Conclusion Nutrition management can effectively maintain the nutritional status of IAI patients, reduce the level of inflammatory factors, protect the intestinal mucosal barrier function, and improve the immune function of the body. So as to improve the prognosis of patients.
【作者單位】： 嘉興市第三醫(yī)院消化內(nèi)科;嘉興市第三醫(yī)院ICU;嘉興市第三醫(yī)院急診科;
【基金】：浙江省醫(yī)藥衛(wèi)生一般研究計(jì)劃基金資助項(xiàng)目(2015KYB353)
【分類(lèi)號(hào)】：R57

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