Moore F A, Moore E E, Kudsk K A, Brown R O, Bower R H, Koruda M J, Baker C C, Barbul A
Department of Surgery, Denver General Hospital, CO 80204-4507.
J Trauma. 1994 Oct;37(4):607-15. doi: 10.1097/00005373-199410000-00014.
In this multicenter prospective controlled trial, 98 evaluable patients sustaining major torso trauma were randomized to receive early enteral nutrition with a new "immune-enhancing" diet (study: n = 51) or a standard stress enteral formula (control: n = 47). At baseline, both groups had comparable demographics and Injury Severity Scores. After 7 days of feeding, the groups had equivalent increases in serum total protein, albumin, and transferrin concentrations. Patients receiving the "immune-enhancing" diet, however, experienced significantly greater increases in total lymphocyte (p = 0.014), T lymphocyte (p = 0.04), and T-helper (p = 0.004) cell numbers. Additionally, these patients had significantly fewer intraabdominal abscesses (study, 0% vs. control, 11%; p = 0.023) and significantly less multiple organ failure (study, 0% vs. control, 11%; p = 0.023). In conclusion, this multicenter trial suggests this "immune-enhancing" enteral diet offers clinical benefits in stressed surgical patients.
在这项多中心前瞻性对照试验中,98例可评估的遭受严重躯干创伤的患者被随机分组,分别接受一种新的“免疫增强”饮食的早期肠内营养(研究组:n = 51)或标准应激肠内配方(对照组:n = 47)。基线时,两组的人口统计学特征和损伤严重程度评分相当。喂养7天后,两组血清总蛋白、白蛋白和转铁蛋白浓度的增加相当。然而,接受“免疫增强”饮食的患者总淋巴细胞(p = 0.014)、T淋巴细胞(p = 0.04)和辅助性T细胞(p = 0.004)数量的增加明显更大。此外,这些患者的腹腔内脓肿明显更少(研究组0% vs. 对照组11%;p = 0.023),多器官功能衰竭也明显更少(研究组0% vs. 对照组11%;p = 0.023)。总之,这项多中心试验表明,这种“免疫增强”肠内饮食对外科应激患者具有临床益处。