| Objectives To observe the protective effect of early application of dietary fiber enteral nutrition on the intestinal tract in patients with intensive care sepsis.Methods All the observed cases were from sepsis patients who were given enteral nutrition from January 2016 to December 2018 in our Department of Intensive Care,a total of 118 cases.According to the number of hospital admission records,the patients were randomly divided into two groups: dietary fiber group treatment group(67 cases)and nondietary fiber group(control group)(51 cases).All patients were given basic treatment such as primary disease treatment,anti-infection and organ function support.In the dietary fiber group,the enteral nutrient was added with fiber components,and the non-dietary fiber group was given only enteral nutrition,all of the patients were continuously treated for 7 days.Observed indicators include basic data(gender,age,weight,and underlying disease distribution),acute and chronic health status scores before and after treatment(APACHE II)/ abdominal circumference,abdominal pressure,and bowel sounds;the values of Serum Dlactate,diamine oxidase values,TNF-? and IL-6,and procalcitonin;Incidence of diarrhea,MODS incidence,and ICU length of stay after treatment,All statistical results of SPSS19.0 statistical software were used for statistical analysis.P<0.05 indicated a statistical difference.Results 1 Comparison of basic data: There was no significant difference in gender,age,weight,and underlying disease distribution between the two groups(P>0.05).The two sets of basic data are comparable.2 Comparison of clinical conditions and signs: The scores of APACHE II(23.47 ± 2.41 vs.22.69 ± 2.46)?and the intra-abdominal pressure(15.81 ± 1.74 vs.13.30 ± 1.78 cmH2O)were markedly decreased,whereas the number of bowel sounds(1.35 ± 0.80 vs.3.35 ± 1.42 per minute)was markedly increased in the non-dietary fiber group after 7 days enteral nutrition was administered compared to the beginning of enteral nutrition(P<0.05);Similarly,the score of APACHE II(23.51 ± 2.22 vs.19.22 ± 2.81),and the intra-abdominal pressure(15.25 ± 1.62 vs.11.87 ± 1.51 cmH2O)were also significantly decreased,whereas the number of bowel sounds(1.31 ± 0.76 vs.4.50 ± 1.45 per minute)were significantly increased in the dietary fiber group after 7 days enteral nutrition was administered compared to the beginning of enteral nutrition(P<0.05).At the 7th day,the score of APACHE II(22.69 ± 2.46 vs.19.22 ± 2.81)and the intra-abdominal pressure(13.30 ± 1.78 vs.11.87 ± 1.51 cmH2O)were significantly declined,whereas the number of bowel sounds(3.35 ± 1.42 vs.4.50 ± 1.45 per minute)was significantly increased in the dietary fiber group compared to the non-dietary fiber group(P <0.05).3 Laboratory serological comparison: the levels of D-lactic acid(23.84 ± 2.77 vs.20.00 ± 3.45 ng/L),and the diamine oxidase(81.06 ± 12.73 vs.57.72 ± 10.84 mIU/ml),and the procalcitonin(6.95 ± 1.29 vs.1.51 ± 0.27 ug/L),TNF-?(38.34 ± 3.12 vs.15.04 ± 2.29 ng/L)and the IL-6(148.77 ± 11.26 vs.70.31 ± 7.64 ng/L)were all markedly decreased in the non-dietary fiber group after 7 days enteral nutrition was administered compared to the beginning of enteral nutrition(P<0.05),Similarly,the levels of D-lactic acid(23.51 ± 2.36 vs.17.97 ± 2.99 ng/L,and the diamine oxidase(80.51 ± 11.97 vs.44.83 ± 7.48 mIU/ml,and the procalcitonin(6.84 ± 1.15 vs.1.40 ± 0.26 ug/L),and the TNF-?(38.07 ± 3.08 vs.12.84 ± 2.19 ng/L)and the IL-6(149.61 ± 9.72 vs.63.46 ± 7.39 ng/L)were all decreased significantly in the dietary fiber group after 7 days enteral nutrition was administered compared to the beginning of enteral nutrition(P<0.05).At the 7th day,the scroe of Dlactic acid(20.00 ± 3.45 vs.17.97 ± 2.99 ng/L),diamine oxidase(57.72 ± 10.84 vs.44.83 ± 7.48 mIU/ml),TNF-?(15.04 ± 2.29 vs.12.84 ± 2.19 ng/L),IL-6(70.31 ± 7.64 vs.63.46 ± 7.39 ng/L)were all significantly decreased in the dietary fiber group compared to the non-dietary fiber group(P <0.05).4 Comparison of the clinical efficacy: After 7 days of enteral nutrition treatment,the incidences of the diarrhea(?2=4.67,P=0.031)were significantly decreased in the dietary fiber group compared to the non-dietary fiber group.Conclusions 1 Enteral nutritional preparations containing dietary fiber are superior to enteral nutritional preparations containing non-dietary fiber in protecting gastrointestinal function recovery,suppressing intestinal inflammation,and reducing complications in patients with sepsis.2 The early application of enteral nutrients preparations containing dietary fiber in sepsis patients can protect intestinal barrier function,adjust the balance of intestinal microflora microenvironment,reduce intestinal and systemic inflammatory reactions,and reduce the incidence of diarrhea.Table15;Reference 88. |
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