机械通气患者医院感染的临床特点及益生菌联合早期肠内营养对其预后影响分析

Clinical Characteristics of Nosocomial Infection in Patients with Mechanical Ventilation and Analysis of the Effect of Probiotics Combined with Early Enteral Nutrition on the Prognosis of Patients with Mechanical Ventilation

摘要: 目的：探讨机械通气患者医院感染的临床特点，并观察益生菌联合早期肠内营养干预对患者预后的影响。方法：抽取本院2016年10月~2018年11月收治的150例机械通气患者，以随机序列软件奇偶数法分为参照组和干预组各75例，参照组采取早期肠内营养支持(Early Enteral Nutrition, EEN)，干预组采取益生菌联合EEN。观察对比两组患者医院感染率、炎症指标和预后结果，并探讨医院感染的特点。结果：干预组总感染率低于参照组，P < 0.05；12例发生感染的患者病原菌以鲍氏不动杆菌、嗜麦芽窄食单胞菌、铜绿假单胞菌、肺炎克雷伯菌为主，占比分别为33.33%、16.67%、16.67%、16.67%；干预组WBC、CRP、PCT均低于参照组，P < 0.05；干预组机械通气时长、住院时间均低于参照组，P < 0.05，且干预组2 W撤机率高于参照组，P < 0.05。结论：益生菌联合EEN能降低机械通气患者院感风险，控制炎症因子水平，改善患者预后质量，值得临床应用。

Abstract: Objective: To investigate the clinical characteristics of nosocomial infection in patients with me-chanical ventilation and to observe the effect of probiotics combined with early enteral nutrition intervention on the prognosis of patients. Methods: From October 2016 to November 2018, 150 patients with mechanical ventilation were randomly divided into two groups: control group (n = 75) and intervention group (n = 75). Early enteral nutrition was used to support Early Enteral Nutrition (EEN) in the control group (n = 75). The intervention group was treated with probiotics combined with EEN. The nosocomial infection rate, inflammatory index and prognosis of the two groups were compared, and the characteristics of nosocomial infection were discussed. Results: The total infection rate of the intervention group was lower than that of the reference group, P < 0.05; in the 12 cases of the infection, the pathogen of the infected patients was the main bacteria of Abalone, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, and Klebsiella pneumoniae, accounting for 33.33%, 16.67%, 16.67%, 16.67%, respectively; WBC, CRP and PCT of the intervention group were all lower than those of the reference group, P < 0.05. The number of PCT was lower than that of the reference group (P < 0.05). The time of the intervention group was lower than that of the reference group (P < 0.05), and the probability of withdrawal of 2 W in the intervention group was higher than that of the reference group (P < 0.05). Conclusion: The combination of probiotics and EEN can be reduced. It is worthy of clinical application to control the risk of the patient’s hospital, to control the level of the inflammatory factors and to improve the quality of the patient’s prognosis.