Effect Of Intestinal Enhanced Immunonutrition On Immune Function And Prognosis In Patients With Severe Pneumonia

BackgroudSevere pneumonia is a clinically common critical illness caused by various pathogen infections.In patients with severe pneumonia,the body is in a highly decomposed state due to fever and infection,so the energy demand is high.Clinical studies have found that the incidence of malnutrition in severe pneumonia is as high as 60%,and malnutrition is easy to cause various complications,leading to systemic organ failure and increase mortality.At the same time,the occurrence and development of severe pneumonia is closely related to the immune status of the body and the release of inflammatory factors.Current researches consider that enteral nutrition can regulate intestinal flora to prevent enterogenic infection,reduce the transfer of intestinal endotoxin,release of inflammatory regulatory factors,and regulate immunity and intestinal function.In this study,patients with severe pneumonia were selected as the main research object.The cellular immune level and inflammatory cytokines were used as observation indicators.At the same time,the intestinal flora and complications of the patients were observed.The patients with severe pneumonia were treated with immune-enhanced enteral nutrition support to explore the effects on immune function,inflammatory cytokines and prognosis.ObjectiveTo observe the effect of intestinal enhanced immunonutrition on stool microflora,immune function,coagulation function and Prognosis inpatients with severe Pneumonia,analyze the curative effect,explore the value of intestinal enhanced immunonutrition in clinical application.Method1?From March 1,2015 to December31,2017,100 Patients with severe Pneumonia admitted to Affiliated hangzhou first people'sHospital Zhejiang University School of Medical were randomly divided into two groups according to the drawing method,50 in the conventional group and 50 in the study group.2?All Patients enrolled in the group were given routine treatment immediately,and given comprehensive treatments such as anti-infection,correction of water and electrolyte disorders,anti-shock,anticoagulant therapy,oxygen therapy,and symptomatic treatment.Enteral nutrition support intervention was initiated 1 day after admission.3?The Patients in the study group were given immuno-enhanced enteral nutrition Preparations for enteral immunization and nutritional support intervention on the basis of routine treatment;the Patients in the conventional group were given standard enteral nutrition support for common enteral nutrition supplements on the basis of conventional treatment.4?Compare the change of stool flora after intervention in the two groups,the changes of immune function and coagulation function before and after intervention,and record the incidence of complications and the number of deaths after intervention.Results1?Changes in stool flora:The incidence of dysbacteriosis in the study group was 4.00%(2/50),which was lower than that in the conventional group(20.00%(10/50),which was statistically significant(P<0.05).2?Changes in immune function:Before the intervention,there was no significant difference in the level of immune function between the two groups(P>0.05).After 1 and 2 weeks of intervention,the levels of CD3+,CD4+,CD4+/CD8+,IgA,IgM and IgG in the two groups were higher than those before the intervention,the difference was statistically significant(P<0.05),and the CD8+ level was higher than before the intervention.The difference was statistically significant(P<0.05).After the intervention,the levels of CD3+,CD4+,CD4+/CD8+,IgA,IgM and IgG were higher in the study group than in the conventional group.The difference was statistically significant.Significance(P<0.05);CD8+ levels were lower than the conventional group,and the difference was statistically significant(P<0.05).3?Changes in inflammatory factor levels:There was no significant difference in inflammatory factor levels between the two groups of patients before intervention(P>0.05).After 1 and 2 weeks of intervention,the levels of TNF-? and IL-6were decreased and the difference was statistically significant(P<0.05).Theanti-inflammatory factor IL-10 increased,There was a statistically significant difference(P<0.05).Compared with the conventional group,the levels of IL-6 and TNF-? showed a downward trend,and the difference was statistically significant(P<0.05).IL-10 level increased,and there was a statistical difference after 2 weeks(P<0.05).4?Prognosis observation:The total incidence of complications in the study group was 10.00%(5/50),which was lower than the general incidence rate of 32.00%(16/50)(p<0.05).One Patient died in the control group and no deaths were found in the study group.ConclusionCompared with the usual enteral nutrition support,intestinal enhanced immunonutrition support can improve the efficacy of severe Pneumonia,improve the immune function and coagulation function of Patients,reduce the occurrence of complications,and thus achieve the Purpose of improving the Prognosis of Patients.