早期肠内营养对重症急性胰腺炎肠源性感染指标的影响  

Effect of early enteral nutrition on index of intestinal infection in severe acute pancreatitis

作　　者：罗洽[1] 谢雏凤飞 孙娟[1] LUO Qia;XIE Chufengfei;SUN Juan(Department of Gastroenterology,the Second Hospital of Sanming City in Fujian Province,Sanming366000,China)

机构地区：[1]福建省三明市第二医院消化内科

出　　处：《中国现代医生》2019年第32期19-21,25,共4页China Modern Doctor

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。方法选取2017年9月~2018年9月我院收治的重症急性胰腺炎肠源性感染患者90例作为研究对象,随机分为常规组与观察组,每组45例,常规组给予肠外营养支持,观察组在入院后第2天给予早期肠内营养支持,比较两组肠源性感染指标(CRP、WBC、内毒素)、急性生理与慢性健康状况评分(APACHEⅡ)与不良反应发生情况。结果观察组不良反应发生率为11.1%,显著低于常规组的28.9%(P<0.05);治疗后观察组肠源性感染指标水平低于常规组(P<0.05);治疗后观察组APACHEⅡ评分为(5.9±2.1)分,显著低于常规组的(10.2±2.8)分(P<0.05);治疗前后各项指标比较差异均有统计学意义(P<0.05)。结论对重症急性胰腺炎肠源性感染患者开展早期肠内营养支持治疗,能减少并发症发生,降低其肠源性感染指标水平,值得在临床治疗中应用。Objective To analyze the effect of early enteral nutrition on intestinal infection markers of severe acute pancreatitis. Methods A total of 90 patients with severe acute pancreatitis and intestinal infection who were admitted to our hospital from September 2017 to September 2018 were enrolled in this study. They were randomly divided into the conventional group and the observation group, with 45 cases in each group. Patients in the conventional group received parenteral nutrition support. The observation group received early enteral nutrition support on the 2 nd day after admission.The index of intestinal infection(CRP, WBC, endotoxin), acute physiology andchronic health status scores(APACHE Ⅱ)and adverse reactions occurrence were compared between the two groups. Results The incidence of adverse reactions in the observation group was 11.1%, which was significantly lower than that in the conventional group(28.9%)(P<0.05). After treatment, the index of intestinal infection in the observation group was lower than that in the conventional group(P<0.05). The APACHE Ⅱ score of the observation group was(5.9±2.1), which was significantly lower than that of the observation group(10.2±2.8) points in the conventional group(P<0.05), and the difference before and after treatment in all indexes were statistically significant(P<0.05). Conclusion Early enteral nutrition support for patients with severe acute pancreatitis and intestinal infection can reduce the incidence of complications and reduce the level of intestinal infection, which is worthy of application in clinical treatment.

关 键 词：重症急性胰腺炎 肠源性感染 早期肠内营养 不良反应 炎性因子 

分 类 号：R576[医药卫生—消化系统]