摘要
目的探讨早期肠内营养支持联合醋酸奥曲肽治疗对急性胰腺炎患者胰腺微循环及并发症的影响。方法急性胰腺炎患者160例,以随机数表法分为两组。对照组给予醋酸奥曲肽治疗,试验组在对照组的基础上加用早期肠内营养支持治疗。比较两组患者临床疗效、胰腺微循环指标[胰腺血容量(BV)、灌注峰值时间(TTP)、胰腺血流量(BF)]水平、淀粉酶(AMY)水平、炎症因子指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)]水平、营养状况[白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TRF)]、肠道功能恢复情况、并发症发生情况。结果试验组总有效率高于对照组。干预后,两组患者TTP水平均降低,BV、BF水平均升高,且试验组TTP(131.02±20.14)0.1 s低于对照组的(179.56±22.23)0.1 s,BV(180.14±17.15)ml/L、BF(131.25±11.24)ml/(100 ml·min)均高于对照组的(147.56±18.06)ml/L、(104.52±11.18)ml/(100 ml·min),差异显著(P<0.05)。干预后,两组患者AMY、CRP、TNF-α、IL-10水平均降低,且试验组患者AMY、CRP、TNF-α、IL-10水平均低于对照组,差异显著(P<0.05)。干预后,两组患者ALB、PAB、TRF水平均高于干预前,且试验组患者ALB(33.45±3.15)g/L、PAB(351.24±24.56)mg/L、TRF(2.91±0.30)g/L均高于对照组的(30.12±3.20)g/L、(301.26±20.16)mg/L、(2.21±0.24)g/L,差异显著(P<0.05)。试验组患者腹痛缓解时间(3.15±0.78)d、腹胀缓解时间(4.51±0.97)d、肠鸣音恢复时间(0.74±0.21)d及重症加强护理病房(ICU)住院天数(13.65±2.51)d均短于对照组的(5.41±0.83)、(6.86±1.34)、(1.74±0.45)、(18.40±1.78)d,差异显著(P<0.05)。两组并发症发生率比较,无显著差异(P>0.05)。结论早期肠内营养支持联合醋酸奥曲肽在急性胰腺炎的治疗中有较好的临床效果,可有效改善患者胰腺微循环,且不增加并发症。
Objective To explore the effects of early enteral nutrition support combined with octreotide acetate on pancreatic microcirculation and complications in patients with acute pancreatitis.Methods A total of 160 patients with acute pancreatitis were divided into two groups by random number table method.The control group was treated with octreotide acetate,and the experimental group was treated with early enteral nutrition support on the basis of the control group.Patients in both groups were compared in terms of clinical efficacy,pancreatic microcirculation indicators[pancreatic blood volume(BV),time to peak(TTP),pancreatic blood flow(BF)]levels,amylase(AMY)levels,inflammatory factor indicators[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)]levels,and nutritional status[albumin(ALB),prealbumin(PAB),transferrin(TRF)],recovery of intestinal function,and occurrence of complications.Results The total effective rate of the experimental group was higher than the control group.After intervention,TTP levels in both groups decreased,while BV and BF levels increased;the experimental group had a lower TTP of(131.02±20.14)0.1 s than(179.56±22.23)0.1 s in the control group;the experimental group had BV of(180.14±17.15)ml/L and BF of(131.25±11.24)ml/(100 ml·min),which were higher than(147.56±18.06)ml/L and(104.52±11.18)ml/(100 ml·min)in the control group;the difference was significant(P<0.05).After intervention,the levels of AMY,CRP,TNF-αand IL-10 in both groups decreased;the levels of AMY,CRP,TNF-αand IL-10 in the experimental group were all lower than those in the control group;the difference was significant(P<0.05).After intervention,the levels of ALB,PAB and TRF in both groups were higher than those before intervention;the experimental group had ALB of(33.45±3.15)g/L,PAB of(351.24±24.56)mg/L and TRF of(2.91±0.30)g/L,which were all higher than(30.12±3.20)g/L,(301.26±20.16)mg/L and(2.21±0.24)g/L in the control group;the difference was significant(P<0.05).In the experimental group,the relief time of abdominal pain was(3.15±0.78)d,the relief time of abdominal distension was(4.51±0.97)d,the recovery time of bowel sounds was(0.74±0.21)d,and the length of intensive care unit(ICU)stay was(13.65±2.51)d,which were shorter than(5.41±0.83),(6.86±1.34),(1.74±0.45),(18.40±1.78)d in the control group,and the difference was significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Early enteral nutrition support combined with octreotide acetate has a good clinical effect on patients with acute pancreatitis,which can effectively improve pancreatic microcirculation without increasing complications.
作者
陈秋云
黄晓铭
CHEN Qiu-yun;HUANG Xiao-ming(Department of Emergency,The First Affiliated Hospital of Xiamen University,Xiamen 361000,China)
出处
《中国现代药物应用》
2025年第13期93-96,共4页
Chinese Journal of Modern Drug Application
关键词
早期肠内营养
醋酸奥曲肽
急性胰腺炎
胰腺微循环
并发症
Early enteral nutrition
Octreotide acetate
Acute pancreatitis
Pancreatic microcirculation
Complications
