摘要
目的探讨超早期肠内营养(EN)联合益生菌对重症急性胰腺炎(SAP)患者的疗效。方法收集2014年12月至2018年6月间南通市第二人民医院收治的75例SAP患者的临床资料,按患者EN实施的时间分为24 h组、72 h组和对照组,每组25例,分别于入院24 h、72 h、7 d给予肠内营养、补充益生菌。入院第1、4、7天检测患者血清降钙素原(PCT)、高敏C反应蛋白(hs-CRP)及内毒素水平,记录患者入院第3天的APACHEⅡ评分以及并发症发生率、感染率、住院时间及病死率。结果入院第1天3组患者血清PCT、hs-CRP和内毒素水平的差异无统计学意义;入院第4天24 h组血清PCT、内毒素水平均显著低于72 h组和对照组[(3.12±1.45)μg/L比(5.26±1.52)、(6.07±1.59)μg/L,(0.24±0.02)EU/ml比(0.35±0.03)、(0.46±0.04)EU/ml],血清hs-CRP水平显著低于对照组[(20.71±4.89)μg/L比(28.37±4.64)μg/L],差异均有统计学意义(P值均<0.05),而24 h组和72 h组的hs-CRP差异无统计学意义。入院第7天24 h组血清PCT、hs-CRP和内毒素水平均显著低于72 h组,72 h组又显著低于对照组,差异均有统计学意义(P值均<0.05)。24 h组入院第3天的APACHEⅡ评分[(15.1±1.8)分]、并发症发生率(52%)、感染率(8%)、住院时间[(19.7±5.3)d]均显著低于72 h组[(17.0±2.0)分、72%、32%、(25.4±6.8)d]和对照组[(18.3±2.6)分、84%、44%、(38.7±12.6)d],差异均有统计学意义(P值均<0.05)。结论超早期EN联合益生菌治疗SAP可明显降低患者血清PCT、hs-CRP和内毒素水平,减少并发症发生率、感染率,缩短住院时间。
Objective To investigate the curative effect of ultra early enteral nutrition(EN)supplemented with probiotics in patients with severe acute pancreatitis(SAP).Methods Seventy-five SAP cases admitted in Second People′s Hospital of Nantong from December 2014 to June 2018 were enrolled and assigned into 24 h group(who received EN&probiotics at 24 h,n=25),72 h group(who received EN&probiotics at 72 h,n=25)and the control group(who received EN&probiotics on day 7,n=25).After admission,the levels of PCT,hs-CRP and endotoxin on day 1,4 and 8 were detected.APACHEⅡscore on day 3 after admission,complication rate,infection rate,hospitalization duration and mortality were recorded.Results On day 1 after admission,serum PCT,hs-CRP and endotoxin concentrations among three groups were of no significant differences.On day 4 after admission,the serum concentrations of PCT and edotoxin in 24 h group were significantly lower than those in 72 h group and the control group[(3.12±1.45)μg/L vs(5.26±1.52),(6.07±1.59)μg/L;(0.24±0.02)EU/ml vs(0.35±0.03),(0.46±0.04)EU/ml].The serum hs-CRP in 24 h group was significantly lower than that of the control group[(20.71±4.89)μg/L vs(28.37±4.64)μg/L],and the difference was statistically significant(P<0.05).The serum concentrations of hs-CRP in 24 h group and 72 h group was of no significant difference.On day 7 after admission,the serum concentrations of PCT,hs-CRP and endotoxin in 24 h group were significantly lower than those in 72 h group and the control group(P<0.05);the serum concentrations of PCT,hs-CRP and endotoxin in 72 h group were significantly lower than those of the control group,and all the differences were statistically significant(all P<0.05).The score of APACHEⅡ(day 3 after admission)[(15.1±1.8)],complication rate(52%),infection rate(8%),length of stay[(19.7±5.3)d]in 24 h group were all significantly lower than those of 72h group[(17.0±2.0),72%,32%,(25.4±6.8)d]and control group[(18.3±2.6),84%,44%,(38.7±12.6)d],and all the differences were statistically significant(all P<0.05).Conclusions Ultra EN supplemented with probiotics in treating the patients with SAP could significantly reduce the level of serum PCT,hs-CRP and endotoxin,decrease complication rate and mortality,and shorten the time of hospitalization.
作者
赵培培
王富兵
范辉
丁锐
缪建林
Zhao Peipei;Wang Fubing;Fan Hui;Ding Rui;Miao Jianlin(Department of Gastroenterology,Second People′s Hospital of Nantong,Nantong 226002,China;Clinical Medicine College of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《中华胰腺病杂志》
CAS
2019年第2期114-117,共4页
Chinese Journal of Pancreatology
关键词
胰腺炎
急性坏死性
有益菌种
肠道营养
Pancreatitis,acute necrotizing
Probiotics
Enteral nutrition
