Zhang Yu, Gu Fang, Wang Fengxian, Zhang Yuanda
Yu Zhang, Baoding Children's Hospital, Baoding 071000, Hebei Province, China.
Fang Gu, Baoding Children's Hospital, Baoding 071000, Hebei Province, China.
Pak J Med Sci. 2016 May-Jun;32(3):599-603. doi: 10.12669/pjms.323.9717.
To evaluate the effects of early enteral nutrition on the gastrointestinal motility and intestinal mucosal barrier of patients with burn-induced invasive fungal infection.
A total of 120 patients with burn-induced invasive fungal infection were randomly divided into an early enteral nutrition (EN) group and a parenteral nutrition (PN) group (n=60). The patients were given nutritional support intervention for 14 days, and the expression levels of serum transferrin, albumin, total protein, endotoxin, D-lactic acid and inflammatory cytokines were detected on the 1st, 7th and 14th days respectively.
As the treatment progressed, the levels of serum transferrin, albumin and total protein of the EN group were significantly higher than those of the PN group (P<0.05), while the levels of serum endotoxin and D-lactic acid of the form group were significantly lower (P<0.05). After treatment, the expression levels of IL-6 and TNF-α were decreased in the EN group, which were significantly different from those of the PN group (P<0.05). During treatment, the incidence rates of complications such as abdominal distension, diarrhea, sepsis, nausea, vomiting and gastric retention were similar. The mean healing time of wound surface was 9.34±0.78 days in the EN group and 12.46±2.19 days in the PN group, i.e. such time of the former was significantly shorter than that of the latter (P<0.05).
Treating patients having burn-induced invasive fungal infection by early enteral nutrition support with arginine can safely alleviate malnutrition and stress reaction, strengthen cellular immune function and promote wound healing, thereby facilitating the recovery of gastrointestinal motility and the function of intestinal mucosal barrier.
评估早期肠内营养对烧伤合并侵袭性真菌感染患者胃肠动力及肠黏膜屏障的影响。
将120例烧伤合并侵袭性真菌感染患者随机分为早期肠内营养(EN)组和肠外营养(PN)组,每组60例。给予患者营养支持干预14天,分别于第1天、第7天和第14天检测血清转铁蛋白、白蛋白、总蛋白、内毒素、D-乳酸及炎性细胞因子的表达水平。
随着治疗进展,EN组血清转铁蛋白、白蛋白和总蛋白水平显著高于PN组(P<0.05),而EN组血清内毒素和D-乳酸水平显著低于PN组(P<0.05)。治疗后,EN组IL-6和TNF-α表达水平降低,与PN组相比差异有统计学意义(P<0.05)。治疗期间,腹胀、腹泻脓毒症、恶心、呕吐及胃潴留等并发症发生率相近。EN组创面平均愈合时间为9.34±0.78天,PN组为12.46±2.19天,即EN组明显短于PN组(P<0.05)。
对烧伤合并侵袭性真菌感染患者采用精氨酸早期肠内营养支持可安全缓解营养不良及应激反应,增强细胞免疫功能,促进创面愈合,从而促进胃肠动力恢复及肠黏膜屏障功能恢复。