Effect of lactobacillus complex capsules combined with nutritional support on nutritional biochemical indices and intestinal microecology in patients with severe pneumonia
Objective To investigate the effect of combined lactobacillus complex capsules and nutritional support on nutritional biochemical indices and intestinal microecology in patients with severe pneumonia.Methods A total of 117 patients with severe pneumonia treated in Zhengzhou Central Hospital from October 2017 to November 2019 were selected as the research subjects.The patients were divided into the control group(n=58)and observation group(n=59)based on their treatment plans.Both groups received basic symptomatic treatment,and on this basis,the control group was given enteral nutritional support,while the observation group was given both enteral nutritional support and lactobacillus complex capsules for two weeks.The duration of mechanical ventilation,hospital stay,length of stay in the intensive care unit,duration of antibiotic use,and incidence of adverse events were recorded and compared between the two groups.The serum albumin(ALB),pre-albumin(PA),and total lymphocyte count(TLC)of patients in the two groups were detected using the fully automatic biochemical analyzer;the proportion of helper T cell(Th)1 and Th2 was detected by flow cytometer,and the Th1/Th2 ratio was calculated;the partial pressure of carbon dioxide(PaCO2),oxygenation index(PaO2/FiO2),and blood oxygen saturation(SaO2)were measured using the blood gas analyzer.Before treatment and after two weeks of treatment,the severity of the disease was evaluated using the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and intestinal microecological indicators(the counts of Lactobacillus,Enterococcus,and Bifidobacterium)were measured.Results The observation group had shorter durations of mechanical ventilation,hospital stay,intensive care unit stay,and antibiotic use compared to the control group(P＜0.05).There were no significant differences in the levels of PA,TLC,and ALB between the two groups before treatment(P＞0.05).After two weeks of treatment,the levels of PA,TLC,and ALB in both groups increased compared to before treatment(P＜0.05),and the observation group had higher levels of PA,TLC,and ALB than the control group(P＜0.05).Before treatment,there were no significant differences in PaO2/FiO2,PaCO2,SaO2,and APACHE Ⅱ score between the two groups(P＞0.05).After two weeks of treatment,both groups had higher PaO2/FiO2 and SaO2,and lower PaCO2 and APACHE Ⅱ score compared to before treatment(P＜0.05).After two weeks of treatment,the observation group had higher PaO2/FiO2 and SaO2,and lower PaCO2 and APACHE Ⅱ score than the control group(P＜0.05).Before treatment,there were no significant differences in Th1 and Th2 proportions and Th1/Th2 ratio between the two groups(P＞0.05).After two weeks of treatment,both groups had higher Th1 proportion and Th1/Th2 ratio and lower Th2 proportion compared to before treatment(P＜0.05).After two weeks of treatment,the observation group had higher Th1 proportion and Th1/Th2 ratio and lower Th2 proportion than the control group(P＜0.05).Before treatment and after two weeks of treatment,there was no significant differences in the counts of Lactobacillus,Enterococcus,and Bifidobacterium between the two groups(P＞0.05);there was no significant differences in the counts of Lactobacillus,Enterococcus,and Bifidobacterium before and after treatment within each group(P＞0.05).The incidences of ventilator-associated pneumonia(VAP),respiratory failure,diarrhea,and 28-day mortality in the control group were 18.97％(11/58),17.24％(10/58),20.70％(12/58),and 5.17％(3/58),respectively;and in the observation group,they were 5.08％(3/59),3.40％(2/59),3.40％(2/59),and 1.70％(1/59),respectively.The incidences of VAP,respiratory failure and diarrhea in the observation group were significantly lower than those in the control group(P＜0.05),and there was no significant difference in the 28-day mortality rate between the two groups(P＞0.05).Conclusion The combination of lactobacillus complex capsules with nutritional support improves the nutritional biochemical indicators and blood gas indicators of patients with severe pneumonia,reduces APACHE Ⅱ scores,and decreases the occurrence of adverse events.
severe pneumonianutritional supportenteral nutritionlactobacillus complex capsulesalbuminlymphocyte countintestinal microecology
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