益生菌联合膳食纤维的肠内营养对重型颅脑损伤患者术后营养状况、免疫功能和肠黏膜屏障功能的影响

摘要 目的：观察重型颅脑损伤患者术后经膳食纤维的肠内营养联合益生菌干预后，患者免疫功能、肠黏膜屏障功能以及营养状况的变化。方法：选取2016年6月~2020年5月期间我院收治的重型颅脑损伤患者136例。根据入院顺序奇偶法分为对照组68例和研究组68例，对照组给予膳食纤维的肠内营养干预，研究组在对照组的基础上联合益生菌干预，对比两组格拉斯哥昏迷量表（GCS）评分、营养状况、免疫功能、肠黏膜屏障功能及并发症发生情况。结果：两组干预14 d后白蛋白（ALB）、血红蛋白（Hb）、转铁蛋白（TR）均较干预前升高，且研究组较对照组高（P<0.05）。两组干预14 d后免疫球蛋白G（IgG） 、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）均较干预前升高，且研究组较对照组高（P<0.05）。两组干预14 d后总超氧化物歧化酶（T-SOD）、谷胱甘肽过氧化物酶（GSH-PX）均较干预前升高，且研究组较对照组高（P<0.05），丙二醛（MDA）较干预前降低，且研究组较对照组低（P<0.05）。两组干预14 d后GCS评分升高，且研究组较对照组高（P<0.05）。研究组的并发症发生率低于对照组（P<0.05）。结论：益生菌联合膳食纤维的肠内营养干预可有效改善重型颅脑损伤术后患者营养状况、免疫功能和肠黏膜屏障功能，同时还可减少并发症发生率，改善患者预后。

Effects of Enteral Nutrition of Probiotics Combined with Dietary Fiber on Nutritional Status, Immune Function and Intestinal Mucosal Barrier Function in Patients with Severe Craniocerebral Injury after Operation

ABSTRACT Objective: To observe the changes of immune function, intestinal mucosal barrier function and nutritional status of patients with severe craniocerebral injury after enteral nutrition with dietary fiber combined with probiotics intervention. Methods: 136 patients with severe craniocerebral injury who were admitted in our hospital from June 2016 to May 2020 were selected. They were divided into 68 cases of control group and 68 cases of study group according to admission sequence parity method, the control group was given enteral nutrition with dietary fiber intervention, while the study group was treated with probiotics intervention on the basis of the control group, the Glasgow coma (GCS) score, nutritional status, immune function, intestinal mucosal barrier function and complications were compared between the two groups. Results: The levels of albumin (ALB), hemoglobin (Hb), transferrin (TR) in the two groups at 14 d after intervention were higher than before intervention, and the study group wsa higher than that of the control group(P<0.05). The levels of immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM) in the two groups at 14 d after intervention were higher than before intervention, and the study group wsa higher than that of the control group (P<0.05). The levels of total superoxide dismutase (T-SOD), glutathione peroxidase (GSH-Px) in the two groups 14d after intervention were higher than before intervention, and the study group was higher than that of the control group (P<0.05), and malondialdehyde (MDA) was lower than before intervention, and the study group was lower than that of control group (P<0.05). GCS scores of the two groups increased 14d after intervention, and the study group was higher than that of the control group (P<0.05). The incidence of complications in the study group was lower than that of the control group (P<0.05). Conclusion: Enteral nutrition of probiotics combined with dietary fiber interventioncan effectively improve the nutritional status, immune function and intestinal mucosal barrier function of patients with severe craniocerebral injury after operation, and can reduce the incidence of complications at the same time, improve the prognosis of patients.