早期肠内营养联合益生菌对急性呼吸窘迫综合征患者预后的影响

探讨早期肠内营养联合益生菌对急性呼吸窘迫综合征（ARDS）患者预后的影响，为该类患者的治疗提供参考。

回顾性分析2018年6月至2020年12月我院急诊ICU收治的86例中重度ARDS患者的临床资料，按随机数字法将患者分为观察组（n = 48例）和对照组（n = 38例）。观察组患者在早期肠内营养基础上联合益生菌治疗，对照组患者采用常规治疗+早期肠内营养进行治疗。统计两组患者性别、年龄、既往基础疾病、原发疾病（包括肺内和肺外）、APACHE Ⅱ评分、SOFA评分、氧合指数、机械通气天数、脱机拔管成功率、ICU以及总的住院天数、28 d病死率等情况。

观察组患者机械通气时间短于对照组[（10.34±2.16）d vs （14.63±3.27）d，P = 0.020]。观察组患者脱机拔管成功率高于对照组（70.83% vs 63.16%，P = 0.038）。观察组患者ICU住院时间短于对照组[（15.34±3.28）d vs （18.68±3.54）d，P = 0.030]。观察组患者28 d病死率低于对照组（22.92% vs 26.32%，P = 0.035）。相关性分析提示早期肠内营养联合益生菌与患者的机械通气天数（r = −0.489，P = 0.039）和病死率（r = −0.312，P = 0.042）均存在相关性。非条件Logistic回归分析显示早期肠内营养联合益生菌能够降低患者的死亡风险。

相比单一予以早期肠内营养，采用早期肠内营养联合益生菌治疗ARDS患者更有利于缩短患者机械通气时间，降低病死率，改善患者的预后。

Effects of early enteral nutrition combined with probiotics on prognoses of patients with acute respiratory distress syndrome

ObjectiveTo observe the effect of early enteral nutrition combined with probiotics on the clinical prognoses of patients with acute respiratory distress syndrome (ARDS), providing a reference for the treatment. MethodsA total of 86 patients with moderate to severe ARDS admitted to the emergency ICU of our hospital from June 2018 to December 2020 were retrospectively analyzed; the patients were divided into observation group (n = 48 cases) and control group (n = 38 cases) randomly. The observation group was treated with probiotics on the basis of early enteral nutrition. The control group was treated with conventional therapy and early enteral nutrition. The gender, age, previous underlying disease, primary disease (including intrapulmonary and extrapulmonary conditions), APACHE Ⅱ score, SOFA score, oxygenation index, days of mechanical ventilation, success rate of off-line extubation, ICU and total hospitalization days, and 28-day death mortality, etc. were compared between groups. ResultsThe mechanical ventilation time in the observation group was shorter than that in the control group [(10.34±2.16) vs (14.63±3.27), P = 0.020]. The success rate of offline extubation in the observation group was higher than that in the control group (70.83% vs 63.16%, P = 0.038). The ICU length of stay in the observation group was shorter than that in the control group [(15.34±3.28) vs (18.68±3.54), P = 0.030], and the 28-day mortality in the observation group was lower than that in the control group (22.92% vs 26.32%, P = 0.035). Correlation analysis showed that early enteral nutrition combined with probiotics was correlated with the mechanical ventilation days (r = −0.489, P = 0.039) and death rate of patients (r = −0.312, P = 0.042). Logistic regression analysis showed that early enteral nutrition combined with probiotics could reduce the risk of death in patients. ConclusionEarly enteral nutrition combined with probiotics in the treatment of ARDS is more conducive to shortening the time of mechanical ventilation, reducing the mortality, and improving the prognoses of patients than early enteral nutrition alone.