【摘要】 目的 探討強化益生元膳食纖維的腸內(nèi)營養(yǎng)在腹部外科術后患者中的臨床應用?！》椒ā?008年7月-2010年11月30例接受腹部外科中等以上手術的患者術前隨機分為研究組和對照組，每組15例。研究組患者于術后接受腸內(nèi)營養(yǎng)，并予以強化益生元膳食纖維；對照組只接受相同的腸內(nèi)營養(yǎng)支持。觀察指標為術后感染并發(fā)癥、胃腸道并發(fā)癥、住院時間、抗生素治療時間、C反應蛋白水平和病死率等?！〗Y(jié)果 研究組術后住院時間為（10±5） d，對照組為（15±7） d，兩組差異有統(tǒng)計學意義（t=2.251，P=0.033）；研究組C反應蛋白水平為（6.6±3.2） mg/L，對照組為（9.8±2.1） mg/L，兩組差異有統(tǒng)計學意義（t=3.238，P=0.003）；研究組抗生素治療時間為（5.0±3.5） d，對照組為（6.0±4.8） d，兩組差異無統(tǒng)計學意義（t=0.652，P=0.520）。兩組均無死亡病例；術后研究組2例發(fā)生感染并發(fā)癥，對照組3例，兩組感染并發(fā)癥發(fā)生率差異無統(tǒng)計學意義（P=1.000）。兩組患者均能耐受經(jīng)腸內(nèi)補充營養(yǎng)素?！〗Y(jié)論 與常規(guī)腸內(nèi)營養(yǎng)比較，給予強化益生元膳食纖維的腸內(nèi)營養(yǎng)能減少腹部外科術后患者的住院時間，降低急性期炎癥反應。【Abstract】 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.
兒童肥胖癥是當前全球面臨的公共健康問題，嚴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系密切，針對腸道微生物組的治療策略對兒童肥胖癥具有一定改善作用。該文對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)展的機制及潛在的干預策略進行了闡述，旨在為兒童肥胖癥的基礎及臨床研究提供更多思路。