Effects Of Early Enteral Nutrition Combined With Probiotics On Nutritional Status And Gastrointestinal Function In Critically Ill Patients

Object:To explorethe influence of Early Enteral Nutrition combined with Probiotics on nutritional status and gastrointestinal function in critically ill patients.Methods:A randomized controlled clinical trial was conducted in this study. 72 critically ill patients were allocated randomly into four groups: EEN group,Jin Shuangqi group, Probiotic Yogurt group and Combined group. 18 critically ill patients with PN delivered at the time severed as Normal Control group.We would respectively measured the weight, TSF,AC, PA,TP,ALB,Hb, lipid levels and humoral immune index, as well as gastrointestinal function index and APACHE II, 28-days mortality at the same time in 0d, 3d,7d and 14 d for all included patients. Analysis of the data was conducted using SPSS 17.0, the t test and repeated measures analysis of variance were used for analysis.Results:(1)For nutritional status, compared with Normal Control group, the PA, HDL-C and C-3 in 14 th dayin four EN groups were significant high(P<0.05).Repeated measures analysis showed that factors such as probiotics and times were significant influence on PA,LDL-C, TC and Ig A(P<0.05).Further pairwise comparison analysis also showed that the PA value in 3 and 14 th day in Combined group was significant higher than that in EEN group and Probiotic Yogurt group(P<0.05); Besides, there were remarkable differences for LDL-C and TC value between Combined and EEN group in 14 th day, as well as the LDL-C between Jin Shuangqi and Probiotic Pogurt group(P<0.05); Furthermore, in 3,7 and 14 th day of EEN group,and in 3 and 14 th day of Jin Shuang qi and Probiotic Yogurt group, the Ig A value was significant lower than that in combined group(P<0.05); However, there was no significant differences between groups of weight, TSF and AC were detected.(2)For gastrointestinal function index,the rate of scour in Probiotic Yogurt group was much lower than that in Combined group(P=0.02); Compared with Combined group, the incidences of constipation in EN group was obviously statistic decreasing(P=0.03).(3)For other indexes,the APACHEⅡ in EN groups in 14 th day was lower than that in Normal Control group(P<0.05); The prevalence of metabolic complications were higher in Normal Control and EEN group than in groups adding probiotics(P<0.05).Conclusion: Jin Shuangqi group ?Probiotic Pogurt group and Combined treatment group not only were effective in the improvement of critically ill patients with enteral nutrition and gastrointestinal function,but also regulate blood lipid levels and humoral immunity; Combined treatment group was more advantage to improve enteral nutrition and gastrointestinal function than others groups; Probiotic pogurt for the regulation of blood lipid level was more obvious than Jin Shuangqi and Combined Treatment group was better to regulate serum protein、blood lipid level、humoral immunity and gastrointestinal function than Jin Shuangqi group、Probiotic Pogurt group,which reduced the APACHE II score and the incidience of metabolic complication of patients.