不同方式营养支持对重症急性胰腺炎患者血浆内毒素水平的影响  

EFFECT OF DIFFERENT NUTRITION SUPPORT ON THE PLASMA LIPOPOLYSACCHARIDE IN THE PATIENTS WITH SERVE ACUTE PANCREATITIS

作　　者：姜雯[1] 郝伟[1] 张风芝[1] 

机构地区：[1]山东省聊城市人民医院营养科,聊城252000

出　　处：《现代预防医学》2010年第9期1764-1765,1767,共3页Modern Preventive Medicine

摘　　要：[目的]探讨不同方式营养支持对重症急性胰腺炎患者血浆内毒素水平的影响。[方法]采用单纯随机抽样方法将符合入选标准的47例重症急性胰腺炎患者随机分为肠内营养联合肠外营养组(PN+EN组,n=24)和完全肠外营养(TPN组,n=23)。两组病人接受同样的基础治疗,所有病人均于营养支持前及营养支持后d3、d7、d10检测血浆内毒素(LPS)浓度,并观察并发症发生情况。结果EN+PN组治疗后血浆内毒素水平较治疗前逐渐降低,而TPN组较治疗前逐渐增高。治疗d7和d10EN+PN组显著低于TPN组,且差异有统计学意义(P﹤0.01)。PN+EN组的并发症发生率低于TPN组,且腹胀和腹泻发生率显著降低(P﹤0.05)。[结论]早期肠内营养可维持肠道黏膜屏障功能,显著降低SAP患者血浆LPS浓度,减少并发症发生。[Objective] To determine the effect of different nutrition support on the concentration of plasma lipopolysaccharide （LPS） of the patients with severe acute pancreatitis. [Methods] Forty-seven patients were randomly divided into enteral nutrition and parenteral nutrition （PN＋EN） group （n=24） and total parenteral nutrition （TPN） group （n=23） .All the patients received the same base therapy and their plasma LPS were checked before the treatment and on the third, the seventh, the tenth day after the treatment of TPN or EN＋PN, their incidence of infection complications were recorded. [Results] After the treatment, the concentration of plasma LPS in EN＋PN group was lower than that of before the treatment, while it was higher in TPN group. On the seventh and the tenth day of the treatment of EN＋PN, the concentration of plasma LPS was lower than that of the TPN group （P﹤0.01）. There was significant difference in complications in two groups. The rates of abdominal distension and diarrhea in PN＋EN group were lower than those of the TPN group （P﹤0.05）. [Conclusion] The enteral nutrition can help maintain the barrier function of mucosal, decrease the concentration of plasma LPS and reduce the rate of complications.

关 键 词：肠内营养 肠外营养 重症急性胰腺炎 内毒素 

分 类 号：R657.51[医药卫生—外科学]