重症急性胰腺炎早期肠内营养对肠源性感染指标的影响  

Impact of early enteral nutrition on enterogenous infection indexes of patients with severe pancreatitis

作　　者：蔡雪军[1] 邵建平[1] 李永元 楚江涛 沈建伟[1] 马亮亮[1] 李灿明[1] CAI Xue-jun;SHAO Jian-ping;LI Yong-yuan;CHU Jiang-tao;SHEN Jian-wei;MA Liang-liang;LI Can-ming(Tianjin Fifth Central Hospital,Tianjin 300450,China)

机构地区：[1]天津市第五中心医院肝胆外科

出　　处：《中华医院感染学杂志》2019年第1期99-101,105,共4页Chinese Journal of Nosocomiology

基　　金：天津市滨海新区卫生局基金资助项目(2015BWKY004)

摘　　要：目的探讨早期肠内营养对重症急性胰腺炎肠源性感染指标的影响。方法选择2015年1月-2017年5月在医院诊断治疗的重症急性胰腺炎的患者60例为研究对象,随机分为研究组与对照组,每组30例。研究组给予早期肠内营养,对照组给予晚期肠内营养,比较两组治疗前后降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数、内毒素水平以及APACHE-Ⅱ评分情况。结果研究组治疗后第4天、第7天及第9天PCT水平、CRP水平、白细胞计数、内毒素水平均低于对照组(P<0.05)。治疗后APACHE-Ⅱ评分均呈下降趋势,治疗后第3天及第7天,研究组APACHE-Ⅱ评分均低于对照组(P<0.05)。两组在胃潴留发生率比较差异有统计学意义(P<0.05)。结论重症急性胰腺炎患者实施早期肠内营养能有效降低肠源性感染指标PCT,CRP,WBC以及内毒素指标水平。OBJECTIVE To explore the impact of early enteral nutrition on enterogenous infection indexes of patients with severe pancreatitis.METHODS A total of 60 patients with severe pancreatitis who were treated in the hospital from Jan 2015 to May 2017 were recruited as the study objects and randomly divided into the study group and the control group,with 30 cases in each group.The study group was treated with early enteral nutrition,while the control group was given late enteral nutrition.The levels of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC)and endotoxin as well as APACHE-Ⅱscore were observed and compared between the two groups of patients before and after the treatment.RESULTS The levels of PCT,CRP,WBC counts and endotoxin of the study group were significantly lower than those of the control group after the treatment for 4,7 and 9 days(P<0.05).The APACHE-Ⅱ score of the two groups of patients showed downward trend after the treatment;the APACHE-Ⅱscore of the study group was lower than that of the control group after the treatment for 3 and 7 days(P<0.05).There was significant difference in the incidence of gastric retention between the two groups(P<0.05).CONCLUSIONThe early enteral nutrition may effectively reduce the levels of enterogenous infection indexes PCT,CRP,WBC and endotoxin of the patients with severe pancreatitis.

关 键 词：早期肠内营养 重症急性胰腺炎 降钙素原 C-反应蛋白 内毒素 

分 类 号：R735.9[医药卫生—肿瘤]