Zhongguo cuzhong zazhi (Oct 2022)

益生菌联合早期肠内营养对重症卒中患者肠道功能影响的meta分析 Effects of Probiotics Combined with Early Enteral Nutrition on Intestinal Function in Patients with Severe Stroke: A Meta-Analysis

  • 王桢桢，李文瑞，张志刚，韩欣怡，马秀娟，张彩云

DOI
https://doi.org/10.3969/j.issn.1673-5765.2022.10.006
Journal volume & issue
Vol. 17, no. 10
pp. 1071 – 1081

Abstract

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目的 应用meta分析评价益生菌联合早期肠内营养对重症卒中患者肠道功能的影响。 方法 计算机检索The Cochrane Library、PubMed、Web of Science、Embase、中国知网、维普、万方、中国生物医学文献数据库中的益生菌联合早期肠内营养治疗对卒中患者营养状况及肠道功能影响的相关文献，2名研究者独立评价文献质量，采用RevMan 5.4统计软件进行meta分析。 结果 最终纳入21篇文献，包括研究对象1838例，其中益生菌联合早期肠内营养组（干预组）920例，常规肠内营养组（对照组）918例。meta分析显示，益生菌联合早期肠内营养可以改善重症卒中患者的营养状况，增加白蛋白（SMD 1.01，95%CI 0.75～1.27，P<0.001）、血红蛋白（SMD 0.96，95%CI 0.60～1.32，P<0.001）水平，提高上臂肱三头肌肌围（SMD 0.60，95%CI 0.28～0.92，P=0.003），降低二胺氧化酶（SMD -1.22，95%CI -1.50～-0.95，P<0.001）、D-乳酸（SMD -1.89，95%CI -2.42～-1.36，P<0.001）水平，减少腹泻（OR 0.24，95%CI 0.14～0.43，P<0.001）、腹胀（OR 0.35，95%CI 0.22～0.58，P<0.001）、便秘（OR 0.37，95%CI 0.15～0.91，P=0.030）等胃肠道并发症的发生。 结论 益生菌联合早期肠内营养可以改善重症卒中患者的营养状况，修复肠粘膜屏障，减少腹泻、腹胀、便秘等胃肠道并发症的发生，对改善患者的肠道功能具有一定的积极效果。 Abstract: Objective To evaluate the effects of probiotics combined with early enteral nutrition on intestinal function in patients with severe stroke using meta-analysis. Methods The Cochrane Library, PubMed, Web of Science, Embase, CNKI, VIP, Wanfang and Chinese Biomedical literature database were retrieved for the literatures on the effects of probiotics combined with early enteral nutrition on nutritional status and intestinal function of stroke patients. Two researchers independently evaluated the literature quality. RevMan5.4 statistical software was used for meta-analysis. Results Twenty-one literatures were included, including 1838 subjects, with 920 cases in the observation group and 918 in the control group. Meta-analysis results showed that probiotics combined with early enteral nutrition can improve the nutritional status of patients with severe stroke, Which can increase the level of albumin (SMD 1.01, 95%CI 0.75-1.27, P<0.001), hemoglobin (SMD 0.96, 95%CI 0.60-1.32, P<0.001), increase midarm muscle circumference (SMD 0.60, 95%CI 0.28-0.92, P=0.003); and reduce the level of diamine oxidase (SMD -1.22, 95%CI -1.50--0.95, P<0.001) and D-lactic acid (SMD -1.89, 95%CI -2.42--1.36, P<0.001), repair intestinal mucous barrier function; reduce diarrhea (OR 0.24, 95%CI 0.14-0.43, P<0.001), abdominal distension (OR 0.35, 95%CI 0.22-0.58, P<0.001), constipation (OR 0.37, 95%CI 0.15-0.91, P=0.030) and other gastrointestinal complications. Conclusions Probiotics combined with early enteral nutrition can improve the nutritional status of patients with severe stroke, repair intestinal mucosal barrier function, reduce the occurrence of gastrointestinal complications such as diarrhea, abdominal distension, and constipation, which has a positive effect on intestinal function of patients.

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