可溶性膳食纤维在重症急性胰腺炎患者早期肠内营养中的应用  

作　　者：赵辉[1] 张超[1] 王佳婷 张梦远 

机构地区：[1]浙江省台州医院,317000

出　　处：《浙江临床医学》2021年第10期1462-1465,共4页Zhejiang Clinical Medical Journal

摘　　要：目的探讨可溶性膳食纤维在重症急性胰腺炎(SAP)患者早期肠内营养(EN)中的应用效果及炎症反应。方法连续性纳入82例SAP患者,随机分为观察组和对照组,每组各41例两组的营养支持方案一致,观察组额外添加可溶性膳食纤维(菊粉)20 g。比较两组患者的胃肠道症状、营养达标情况和营养指标、肠道粘膜屏障指标、炎症因子水平结果观察组食物不耐受综合征、胃潴留和腹泻的发生率均低于对照组(P<0.05)。观察组患者入院第3天、第5天和第7天的热卡达标率均优于对照组(P<0.05)。观察组入院第5天和第7天的蛋白达标率均优于对照组(P<0.05)。观察组入院第7天的血清前白蛋白、转铁蛋白水平均高于对照组(P<0.05)。观察组入院第5天和第7天的血清内毒素、D-乳酸水平均低于对照组(P<0.05)。观察组入院第7天的血清二胺氧化酶水平低于对照组(P<O.05)。观察组入院第5天和第7天的血清TNF-α和CRP水平均低于对照组(P<0.05)。结论添加可溶性膳食纤维有助于提升SAP患者早期EN喂养的质和量,保护肠道粘膜屏障,降低炎症反应水平。Objective To explore the effect of soluble dietary fiber on feeding efficiency of early enteral nutrition(EN) and inflammatory response in patients with severe acute pancreatitis(SAP).Methods A total of 82 SAP pcitients were continuously enrolled and randomly divided into an observation group and a control group,with 41 patients in each group.The nutrition support was same in both groups,and 20 g soluble dietary fiber(inulin)was added to the observarion group.Gastrointestinal symptoms,nutritional standards and nutritional indicators,intestinal mucosal barrier indicators and inflammatory factor levels were compared between the two groups.Results The incidence of food intolerance syndrome,gastric retention and diarrhea in the observation group were lower than those in the control group(P<0.05).The rate of calorie retention in the observation group was better than that in the control group on the 3rd,5th and 7th day of admission(P<0.05).The protein compliance rate of the observation group on the 5th and 7th day of admission was better than that of the control group(P<0.05).The levels of semm prealbumin and transferrin in the observation group were higher than those in the control group on the 7th day of admission(P<0.05).The levels of serum endotoxin and D-lactic acid in the observation group were lower than those in the control group on day 5 and 7(P<0.05).The level of serum diamine oxidase in the observation group was lower than that in the control group on the 7th day after admission(P<0.05).The serum TNF-α and CRP levels in the observation group were lower than those in the control group on day 5 and 7(P<0.05).Conclusion Additional soluble dietary fiber can improve the feeding quality and quantity of early EN,protect intestinal mucosal barrier and decrease inflammatory response level in SAP patients.

关 键 词：膳食纤维 重症急性胰腺炎 肠内营养 炎症反应 

分 类 号：R47[医药卫生—护理学]