【摘要】 目的 探討強(qiáng)化益生元膳食纖維的腸內(nèi)營養(yǎng)在腹部外科術(shù)后患者中的臨床應(yīng)用?！》椒ā?008年7月-2010年11月30例接受腹部外科中等以上手術(shù)的患者術(shù)前隨機(jī)分為研究組和對(duì)照組，每組15例。研究組患者于術(shù)后接受腸內(nèi)營養(yǎng)，并予以強(qiáng)化益生元膳食纖維；對(duì)照組只接受相同的腸內(nèi)營養(yǎng)支持。觀察指標(biāo)為術(shù)后感染并發(fā)癥、胃腸道并發(fā)癥、住院時(shí)間、抗生素治療時(shí)間、C反應(yīng)蛋白水平和病死率等。 結(jié)果 研究組術(shù)后住院時(shí)間為（10±5） d，對(duì)照組為（15±7） d，兩組差異有統(tǒng)計(jì)學(xué)意義（t=2.251，P=0.033）；研究組C反應(yīng)蛋白水平為（6.6±3.2） mg/L，對(duì)照組為（9.8±2.1） mg/L，兩組差異有統(tǒng)計(jì)學(xué)意義（t=3.238，P=0.003）；研究組抗生素治療時(shí)間為（5.0±3.5） d，對(duì)照組為（6.0±4.8） d，兩組差異無統(tǒng)計(jì)學(xué)意義（t=0.652，P=0.520）。兩組均無死亡病例；術(shù)后研究組2例發(fā)生感染并發(fā)癥，對(duì)照組3例，兩組感染并發(fā)癥發(fā)生率差異無統(tǒng)計(jì)學(xué)意義（P=1.000）。兩組患者均能耐受經(jīng)腸內(nèi)補(bǔ)充營養(yǎng)素?！〗Y(jié)論 與常規(guī)腸內(nèi)營養(yǎng)比較，給予強(qiáng)化益生元膳食纖維的腸內(nèi)營養(yǎng)能減少腹部外科術(shù)后患者的住院時(shí)間，降低急性期炎癥反應(yīng)?！続bstract】 Objective To investigate the effect of early enteral supply of prebiotic fiber in patients undergoing major abdominal surgery. Methods Between July 2008 and November 2010, 30 patients undergoing major gastrointestinal surgery were randomized into the study group and the control group before operation with 15 patients in each group. Prebiotic fiber was administered combined with enteral nutrition support for patients in the study group. Patients in the control group only received conventional enteral nutrition without fiber. The main endpoints included the development of bacterial infection, the duration of hospital stay, antibiotic therapy, the serum level of C-reaction protein (CRP), side effects of the enteral nutrition and morbidity. Results Compared with the control group, the median duration of hospital stay was shorter in the study group [(15±7) days in the control group vs. (10±5) days in the study group; t=2.251, Plt;0.05]. The mean level of CRP was also lower in the study group [(6.6±3.2) mg/L] than that in the control group [(9.8±2.1) mg/L] (t=3.238, Plt;0.05). The enteral nutrition and fibers were well tolerated. The incidence of infectious complications (3 cases in the control group vs. 2 cases in the study group) and the median duration of antibiotic therapy [(6.0±4.8) days in the control group vs. (5.0±3.5) days in the study group] were not significantly different between the two groups (t=0.652, Pgt;0.05). No patients died in both the two groups. Conclusion Compared with the conventional enteral nutrition, early enteral supply of prebiotic fiber can reduce the duration of hospital stay and acute phase response.
兒童肥胖癥是當(dāng)前全球面臨的公共健康問題，嚴(yán)重影響兒童的正常生長發(fā)育。近年來大量研究指出，腸道微生物組與兒童肥胖癥關(guān)系密切，針對(duì)腸道微生物組的治療策略對(duì)兒童肥胖癥具有一定改善作用。該文對(duì)兒童微生物組的建立和發(fā)展、肥胖癥兒童腸道微生物組特征、腸道微生物組參與兒童肥胖癥發(fā)生發(fā)展的機(jī)制及潛在的干預(yù)策略進(jìn)行了闡述，旨在為兒童肥胖癥的基礎(chǔ)及臨床研究提供更多思路。