摘要
目的分析超早期肠内营养联合微生态制剂与延迟肠内营养治疗重症急性胰腺炎患者的临床价值。方法回顾性分析蚌埠医学院第一附属医院急诊科2013年1月至2017年10月收治的30例符合重症急性胰腺炎诊断标准患者的临床资料，其中15例入院24h内给予肠内营养联合微生态制剂（治疗组），15例入院48h后仅给予延迟肠内营养制剂（对照组）。治疗2周后比较两组患者血清C-反应蛋白、总蛋白、白蛋白、尿淀粉酶恢复时间、血淀粉酶恢复时间、住院时间和急性生理及慢性健康状况评分Ⅱ（APACHEⅡ）。两组间比较用成组t检验。结果与延迟肠内营养治疗相比，采用超早期肠内营养联合微生态制剂治疗可明显降低重症急性胰腺炎患者血清C-反应蛋白[（46．7±13．1）mg／Lw．（190．72±19．3）mg／L，t=10．4，P〈0．01]和APACHEⅡ评分[（7．2±1．9）vs．（9．3±2．4），t=2．7，P〈0．05]，提高血清总蛋白[（58．1±6．3）g/L vs．（52．6±5．4）g/L，t=2．5，P〈0．05]、白蛋白[（29．9±3．2）g／L vs．（22．0±2．8）g/L，t=7．12，P〈0．01]，缩短尿淀粉酶恢复时间[（13．2±2．1）d vs．（18．7±3．9）d，t=4．9，P〈0．01]、血淀粉酶恢复时间[（7．5±3．0）d vs．（11．1±3．4）d，t=3．1，P〈0．01]及住院时间[（14．9±4．5）d vs．（27．1±5．3）d，t=6．9，P〈0．01]，两组相比差异有统计学意义。结论超早期肠内营养联合微生态制剂干预可改善重症急性胰腺炎患者临床疗效。
Objective To analyze the clinical values of super early enteral nutrition combined with microecopharmaceutics and delayed enteral nutrition on patients with severe acute pancreatitis. Methods Clinical data of thirty patients diagnosed as severe acute pancreatitis in our emergency department during January 2013 and December 2017 were reviewed retrospectively. Patients were divided into the treatment group （n=15, patients given enteral nutrition combined with microecopharmaceutics within 24 h after admission） and the control group （n=15, patients given delayed enteral nutrition after 48 h of admission）. Two weeks after the treatment, the serum variables of C-reactive protein, total protein, albumin, recovery time of urine and blood amylase, length of hospital stay and APACHE Ⅱ score were compared between the two groups by using paired samples t test. Results The C-reactive protein [（46.7 ± 13.1） mg/L vs. （190.72 ±19.3） mg/L, t=10.4, P〈0.01] and APACHE Ⅱ score [（7.2 ± 1.9） vs. （9.3±2.4）, t=2.7, P〈0.05] of the treatment group were significantly lower than those in the control group. The total protein [（58.1 ± 6.3）g/L vs. （52.6 ± 5.4） g/L, t=2.5, P〈0.05] and albumin [（29.9 ±3.2）g/L vs. （22.0± 2.8） g/L, t=7.12, P〈0.01] of the treatment group were significantly higher than those in the control group. The recovery time of urine amylase [（13.2± 2.1）d vs. （18.7 ± 3.9） d, t=4.9, P〈0.01] and blood amylase [（7.5 ±3.0）d vs. （11.1 ± 3.4） d, t=3.1, P〈0.01 ], and length of hospital stay[（14.9 ±4.5）d vs. （27.1 ± 5.3） d, t=6.9, P〈0.01] were significantly shorter in the treatment group compared with those in the control group. Conclusions Ultra-early enteral nutrition combined with microecopharmaceutics can shorten the length of hospital stay of patients with severe acute pancreatitis, and is safe and effective.
作者
邱兆磊
王振杰
程峰
宋琦
徐志鹏
邵志林
郑传明
李磊
姜海
杜召辉
窦贺贺
Qiu Zhaolei;Wang Zhenjie;Cheng Feng;Song Qi;Xu Zhipeng;Shao Zhilin;Zheng Chuanming;Li Lei;Jiang Hai;Du Zhaohui;Dou Hehe(Department of Emergent Surgery,the Frist Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2018年第9期967-971,共5页
Chinese Journal of Emergency Medicine
基金
安徽省教育厅自然科学项目（KJ20158113by）
蚌埠医学院科技发展项目（BYKF1768）
关键词
重症急性胰腺炎
超早期肠内营养
延迟肠内营养
益生菌
Severe acute pancreatitis
Ultra-early enteral nutrition
Delayed enteral nutrition
Probiotics
作者简介
通信作者：王振杰，Email：ahbyfywzj@163．com
