摘要
目的观察早期肠内营养对胰十二指肠切除术(PD)后急性炎症反应的影响。方法将53例胰十二指肠切除术患者,随机分为肠内营养(EN)组和肠外营养(PN)组,术后24 h开始分别接受肠内和肠外营养,检测两组患者术前和术后血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)等急性炎症反应指标,并观察术后全身炎症反应综合征(SIRS)及多器官功能不全综合征(MODS)的发生率。结果两组患者术后均有急性炎症反应的发生,EN组术后第3、7天的CRPI、L-6、TNF-α血清水平较PN组有显著下降(P<0.05);EN组SIRS持续时间(3.58±1.24)d明显短于PN组(5.81±1.57)d(P<0.01);EN组的MODS发病率(11.5%)明显低于PN组(25.9%)(P<0.01)。结论PD术后早期肠内营养能有效地减轻创伤后的急性炎症反应,降低MODS发病率,促进患者康复。
Objective To observe the effects of early enteral nutrition （EN） on acute inflammatory response after pancreaticoduodenectomy. Methods According to random table, 53 cases of postoperative patients with pancreaticoduodenectomy were divided into two groups accepting early enteral or parenteral nutritional support respectively. Indexes of acute inflammatory response such as CRP, IL-6 and TNF-a were measured one the day before operation and on the postoperative day 1, 3 and 7. At the same time, the clinical conditions of patients with SIRS and MODS were observed and analyzed. Results Patients in both groups had acute inflammatory response after pancreaticoduodenectomy. The levels of CRP, IL-6 and TNF a on the day 3 and 7 after pancreaticoduodeneetomy were lower in the EN group than those in the parenteral nutrition （PN） group. The duration of SIRS in the EN group was significantly shorter than that in the PN group. The morbidity of MODS was lower significantly in the EN group than that in the PN group. Conclusion Early postoperative EN after pancreaticoduodenectomy can positively modulate the acute inflammatory response and decrease the morbidity of MODS.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2006年第2期256-258,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
胰十二指肠切除术
肠内营养
全身炎症反应综合征
多器官功能不全综合征
pancreatieoduodenectomy
enteral nutrition, systemic inflammatory response syndrome
multiply organ dysfunction syndrome
