| Objective:Through enteral immune microecological nutrition(EIMN)nutritional support,it can reduce the incidence of infectious complications after intrahepatic bile duct stones(HL),improve the nutritional status,immunity and liver function indicators,and shorten the hospital number of days of patients.Methods:This study used a randomized controlled trial design.108 patients with intrahepatic bile duct stones admitted to a tertiary hospital from June to December2022 in 2022 were included.Using the coin toss method,randomization was performed,the intervention group was enteral immune microecological nutrition group and the control group was routine nutrition support group with 54 cases in each group.The control group was given conventional nutrition(parenteral nutrition and enteral nutrition),and conventional intravenous supplementation of glucose,vitamins,electrolytes on the first day after surgery.After ventilation,enteral nutrition was routinely performed,that is,with Ann enteral nutrition powder,supplemented by 6spoons of Ann powder with 200ml warm water about 250kcal,35 times orally,3times/d.If the serum albumin value is lower than 30g/L,refer to the patient weight,estimate the daily heat card(25 kcal/kg/d)and kg/d,and intravenous infusion of2000-ml total nutrition(0.15～0.2 g/kg/d)nutritional support.On the basis of the control group,the intervention group added immune microecological enteral nutrition preparation(EIMN),6 compound glutamine enteric capsules/day,and 6bifidobacterium enteric capsules/day.The intervention time was one week.The postoperative infectious complications,such as abdominal infection,incisional infection,pulmonary infection,were obtained before the group and 7 days after surgery,such as albumin(ALB),CD4+,CD8+and CD4+/CD8+and immune function related indicators,such as alanine transaminotransferase(ALT(ALT),(transaminase)AST,(total bilirubin)TBIL,(direct bilirubin)DBIL,etc.Results:A total of 108 patients were included,and no patients were eliminated,and all patients completed the study.1.Comparison of baseline data between the two groups:general demographic data,such as gender,age,classification,disease course,maximum stone diameter,and nutritional risk screening score,showed no statistical difference(P>0.05),indicating that the data between the two groups were comparable.2.Post-intervention results:(1)Infectious complications:The comparison showed 10 cases of infections in the control group and 3 cases in the intervention group,and the incidence of infectious complications was significantly reduced(x~2=4.285,P<0.05).(2)Nutritional status:ALB and PAB were significantly higher than preoperative(P<0.001);compared between groups,no difference between preoperative ALB and PAB(P>0.05);ALB and PAB values after intervention were higher than that of the control group(P<0.05),indicating that the intervention was effective.(3)Immunization indicators:CD4+and[CD4+/CD8+]were significantly higher compared with preoperative comparison(P<0.001),but the increase in CD8+intervention was not significant(0.001<P<0.05).Comparison between groups:preoperative CD4+,CD8+,[CD4+/CD8+](P>0.05);after intervention,CD4+,CD8+,[CD4+/CD8+],the intervention group was higher than the control group(P<0.05),indicating that the intervention was effective.(4)Liver function indicators:before and after the two groups,the results showed no significant differences in ALT,AST,TBIL and DBIL(P>0.05).(5)Mean hospitalization days:the results of the between-group comparison showed that the hospitalization days of the intervention group were 3.5 days less than the control group,which was statistically significant(P<0.05)Conclusion:Early EIMN support can reduce the incidence of postoperative infectious complications in HL patients,improve the postoperative nutritional status,improve immune function and shorten the length of hospitalization in HL patients,but have no obvious effect on the improvement of liver function.Therefore,medical staff deserve early EIMN support for HL patients to facilitate early postoperative rehabilitation. |
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