早期肠内营养对急性胰腺炎并发多脏器功能衰竭患者免疫功能及营养状态的影响  

Effect of early enteral nutrition on immune function and nutritional status in patients with acute pancreatitis complicated with multiple organ failure

作　　者：邵志永[1] 王博琪 杨培光 SHAO Zhiyong;WANG Boqi;YANG Peiguang(Yongcheng People′s Hospital,Yongcheng 476600,Henan province,China;Yongcheng Red Cross Hospital,Yongcheng 476600,Henan province,China)

机构地区：[1]永城市人民医院 [2]永城市红十字医院,河南省永城市476600

出　　处：《内科》2019年第5期535-538,共4页Internal Medicine

摘　　要：目的观察早期肠内营养对急性胰腺炎并发多脏器功能衰竭患者免疫功能及营养状态的影响。方法选择2017年2月至2018年8月本院收治的急性胰腺炎并发多脏器功能衰竭患者98例,根据随机数字表法分为两组,每组49例。两组患者均给予常规综合治疗,在此基础上,对照组患者给予延期肠内营养(DEN)支持,观察组患者给予早期肠内营养(EEN)支持。比较两组患者的免疫指标、营养状态指标和临床相关指标的变化情况。结果干预2周后,两组患者的CD3^+细胞、CD4^+细胞、CD4^+/CD8^+细胞、NK细胞、B淋巴细胞、Ig A、Ig G、Ig M水平均有所增高,观察组患者的水平显著高于对照组,差异有统计学意义(P<0.05);两组患者的前白蛋白(PA)、转铁蛋白(TRF)以及白蛋白(Alb)水平均有所增高,观察组患者的水平显著高于对照组,差异有统计学意义(P<0.05);观察组患者的APACHEⅡ评分显著低于对照组,SIRS改善时间和住院时间也显著短于对照组,差异有统计学意义(P<0.05)。结论早期肠内营养支持可有效增强急性胰腺炎并发多脏器功能衰竭患者的免疫功能,改善患者的营养状态和临床症状,有利于促进患者早日康复。Objective To observe the effect of early enteral nutrition on immune function and nutritional status in patients with acute pancreatitis complicated with multiple organ failure.Methods A total of 98 patients with acute pancreatitis complicated with multiple organ failure admitted to our hospital from February 2017 to August 2018 were selected,and were divided into two groups according to random number table method,with 49 cases in each group.Both groups received conventional comprehensive treatment.On the basis of conventional comprehensive treatment,the control group received support of delayed enteral nutrition(DEN),and the observation group received early enteral nutrition(EEN)support.The changes of immune index,nutritional status index and clinical relevant indicators were compared between the two groups.Results After 2 weeks of treatment,the CD3^+cells,CD4^+cells,CD4^+/CD8^+cells,NK cells,B lymphocytes,Ig A,Ig G,and Ig M levels were increased in the two groups,and the levels were significantly higher in the observation group than in the control group,with statistically significant difference(P<0.05).The levels of prealbumin(PA),transferrin(TRF)and albumin(Alb)were increased in the two groups,whereas the levels of the observation group were significantly higher than those of the control group.The difference was statistically significant(P<0.05).The APACHE II score of the observation group was significantly lower than that of the control group,and the improvement time of SIRS and hospital stays were significantly shorter in the observation group than in the control group,with statistically significant difference(P<0.05).Conclusion The support of EEN on acute pancreatitis complicated with multiple organ failure can effectively enhance the immune function,improve nutritional status and clinical symptoms.It is beneficial to promote a speedy recovery of patients.

关 键 词：急性胰腺炎 多脏器功能衰竭 早期肠内营养 免疫功能 营养状态 

分 类 号：R576[医药卫生—消化系统]