早期免疫肠内营养支持在急性重症胰腺炎患者治疗中的应用研究  

Application of early stage immunity enteral nutrition support in the treatment of patients with acute severe pancreatitis

作　　者：李艳丽[1] 游丽 李曦杨 陈泽容 梁立平[1] 张智荣[1] 黄媛 LI Yan-li;YOU Li;LI Xi-yang;CHEN Ze-rong;LIANG Li-ping;ZHANG ZHi-rong;HUANG Yuan(Department of Severe Medicine,The First Affiliated Hospital,Chengdu Medical College,Chengdu 610500,China;Rescue Level 16,The Thirteenth Team of the Third Brigade,The Armed Police Logistics College,Tianjin 300309,China)

机构地区：[1]成都医学院第一附属医院重症医学科,四川成都610500 [2]武警后勤学院三大队十三队,天津300309

出　　处：《实用医院临床杂志》2019年第5期26-29,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨早期免疫肠内营养支持(ESIEN)在急性重症胰腺炎(SAP)患者治疗中的应用价值。方法我院收治的SAP患者128例,按随机数字表法分为ESIEN组和对照组各64例。在常规治疗基础上,对照组给予肠外营养,ESIEN组给予ESIEN。观察两组治疗前后肠黏膜屏障功能指标、营养指标、T细胞亚群、免疫球蛋白、炎性因子等指标。结果治疗后,ESIEN组血脂肪酶、血淀粉酶、D-乳酸、降钙素原、CD4^+、CD8^+、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)水平均低于对照组,转铁蛋白、前白蛋白、白蛋白、总蛋白、CD4^+/CD8^+、IgA、IgG、IgM水平均高于对照组(P<0.05)。结论ESIEN应用于SAP的临床治疗,可为患者提供充足的营养,有效促进肠黏膜屏障功能恢复,改善肠道微生态环境,提高免疫功能,清除炎性因子,益于患者康复。Objective To investigate the application of early stage immunity enteral nutrition(ESIEN)in the treatment of patients with acute severe pancreatitis(SAP).Methods One hundred and twenty-eight SAP patients admitted to our hospital were randomly divided into ESIEN or control group,64 in each group.Both groups received routine treatment.The control group received off-site nutrition,and the ESIEN group received ESIEN.The intestinal mucosal barrier function index,nutrition index,T cell subsets,immunoglobulin,inflammatory factors and other indexes were observed before and after treatment.Results After treatment,the levels of serum lipase,amylase,D-lactic acid,procalcitonin,CD4^+,CD8^+,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in the ESIEN group were lower than those in the control group while the levels of transferrin,prealbumin,albumin,total protein,CD4^+/CD8^+,IgA,IgG and IgM in the ESIEN group were higher than those in control group(P<0.05).Conclusion Application of ESIEN to SAP patients can provide sufficient nutrition for patients,effectively promote the recovery of intestinal mucosal barrier function,the intestinal micro-ecological environment and the immune function and eliminate the inflammatory factors.These are benefit for recovery of the patients.

关 键 词：早期免疫肠内营养支持 急性重症胰腺炎 肠外营养支持 胃肠功能 营养 免疫因子 炎性因子 

分 类 号：R576[医药卫生—消化系统]