埃索美拉唑联合早期肠内营养治疗重症急性胰腺炎的临床研究  

Effects of Esomeprazole combined with early enteral nutrition in patients with severe acute pancreatitis

作　　者：田笑笑[1] 杜浩[1] 白艳丽[1] 朱晶晶[1] 张瑜[1] 张亚历[2] 

机构地区：[1]河南科技大学第一附属医院,洛阳市471003 [2]南方医科大学南方医院,广州市510515

出　　处：《实用医学杂志》2015年第10期1695-1698,共4页The Journal of Practical Medicine

基　　金：河南科技大学校青年基金资助项目(编号:2012QN028)

摘　　要：目的:研究埃索美拉唑联合早期肠内营养治疗重症急性胰腺炎的疗效及对其预后的影响。方法:根据治疗方法将68例重症急性胰腺炎患者随机分为全肠外营养组(TPN组,n=21)、早期肠内营养组(EEN组,n=24)和埃索美拉唑联合早期肠内营养组(E+EEN组,n=23),比较各组治疗后APACHEⅡ评分、血清hs-CRP、IL-6、TNF-α浓度变化及观察各组患者继发感染率、手术率、死亡率、住院时间和平均住院费用。结果:治疗后第7、14天,3组患者APACHEll评分、血清hs-CRP、IL-6、TNF-α浓度均显著低于治疗前(P<0.05),TPN组、EEN组和E+EEN组患者治疗后的APACHEll评分、血清hs-CRP、IL-6、TNF-α浓度依次显著降低(P<0.05);与TPN组比较,EEN组、E+EEN组的继发感染率、手术率、死亡率、平均住院时间和费用均明显降低(P<0.05),E+EEN组最低,但平均住院时间和费用相比较E+EEN组与EEN组之间差异无显著性(P>0.05)。结论:埃索美拉唑联合早期肠内营养可显著降低SAP患者血清炎性因子浓度,降低继发感染率、手术率及死亡率,疗效优于单纯早期肠内营养和全肠外营养。Objective To analyse the effects of Esomeprazole combined with early enteral nutrition in Patients with Severe Acute Pancreatitis （SAP）. Methods Six-eight cases with severe acute pancreatitis were randomly divided into total parenteral nutrition group （TPN group, n = 21 ）, early enteral nutrition group （EEN group, n = 24）, Esomeprazole and early enteral nutrition group （E＋EEN group, n = 23）. APACHE II scores and the concentration of hs-CRP, IL-6, TNF-ctwere compared in three groups after treatment. The secondary infection rate, operability, mortality, duration and treatment costs were compared as well. Results APACHE II scores, serum concentration of hs-CRP, IL-6 and TNF-c~ of all 3 groups patients were significantly lower after seven- and fourteen-day treatment （P 〈 0.05）, all the above indexes of patients of TPN group, EEN group and E＋EEN group were decreased orderly（P 〈 0.05）. The secondary infection rate, operability, mortality, duration and treatment costs were significantly decreased in EEN and E ＋EEN group when compared with those in TPN group, （P 〈 0.05） with the lowest in E＋EEN group. But there were no significantly differences of duration and treatment costs between EEN and E ＋EEN group （P 〉 0.05）. Conclusion The serum concentration of inflammatory factors, secondary infection rate, operability and mortality are notably decreased by Esomeprazole combined with early enteral nutrition in patients with SAP.

关 键 词：埃索美拉唑 早期肠内营养 重症急性胰腺炎 炎性因子 

分 类 号：R576[医药卫生—消化系统]