不同肠内营养滴注速度对重症急性胰腺炎患者喂养耐受性及营养状况的影响  

Effects of different enteral nutrition infusion rates on feeding tolerance and nutritional status in patients with severe acute pancreatitis

作　　者：覃宁 Qin Ning(Health Management(Physical Examination)Center,The Second People’s hospital of Qinzhou,Qinzhou 535000,China)

机构地区：[1]广西钦州市第二人民医院健康管理(体检)中心,钦州535000

出　　处：《广西医科大学学报》2022年第7期1141-1146,共6页Journal of Guangxi Medical University

摘　　要：目的:研究不同肠内营养滴注速度对重症急性胰腺炎患者喂养耐受性及营养状况的影响。方法:选择2018年2月至2020年2月在广西钦州市第二人民医院住院的96例重症急性胰腺炎患者,按照不同的输液速度将患者分为A组、B组和C组,每组32例。A组初始速度30 mL/h,20 h之内增加至80 mL/h(低速);B组初始速度30 mL/h,16 h之内增加至80 mL/h(中速);C组初始速度30 mL/h,12 h之内增加至80 mL/h(高速);记录3组在肠内营养期间出现喂养不耐受的发生率,分别在治疗前、治疗后两周测定3组的转铁蛋白、白蛋白、前白蛋白、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α),比较3组治疗前、治疗后12 h、24 h、72 h的腹内压水平,对比3组干预结果。结果:A组喂养不耐受的发生率均低于B组、C组(P<0.05)。治疗前3组的各项营养指标对比差异无统计学意义(P>0.05),治疗后A组高出B组、C组(P<0.05)。治疗前3组的腹内压相比差异无统计学意义(P>0.05),A组治疗后12 h、24 h、72 h的腹内压均低于B组、C组(均P<0.05)。治疗前3组的炎性指标相比差异无统计学意义(P>0.05),A组治疗后CRP、IL-6、TNF-α均低于B组、C组(P<0.05)。结论:重症急性胰腺炎患者实施肠内营养时,低速递增输注方式的效果更突出,可快速减低患者腹内压,并防止喂养不耐受现象产生,同时增强患者营养状况,清除炎性反应,为预后提供保障。Objective:To research the effects of different enteral nutrition infusion rates on feeding tolerance and nutritional status in patients with severe acute pancreatitis.Methods:Ninety-six patients with severe acute pancreatitis hospitalized in The Second People’s hospital of Qinzhou,Guangxi from February 2018 to February 2020 were divided into group A,group B and group C,with 32 cases in each group.The initial speed of group A increased from 30 mL/h to 80 mL/h within 20 h(low speed),that of group B increased from 30 mL/hto 80 mL/h within 16 h(medium speed),and that of group C increased from 30 mL/h to 80 mL/h within 12 h(high speed).The incidence of feeding intolerance in the three groups during enteral nutrition was recorded.The levels of transferrin,albumin,prealbumin,C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured before treatment and two weeks after treatment.The levels of intra-abdominal pressure of the three groups before treatment,12 h,24 h and 72 h after treatment were compared.The intervention results of the three groups were compared.Results:The incidence of feeding intolerance in group A was lower than that in group B and group C(P<0.05).There was no significant difference in nutritional indexes among the three groups before treatment(P>0.05).After treatment,the nutritional indexes in group A were higher than those in group B and group C(P<0.05).There was no significant difference in intra-abdominal pressure among the three groups before treatment(P>0.05).The intra-abdominal pressure at 12 h,24 h and 72 h after treatment in group A was lower than that in group B and group C(all P<0.05).There was no significant difference in inflammatory indexes among the three groups before treatment(P>0.05).After treatment,CRP,IL-6 and TNF-α in group A were lower than those in group B and group C(P<0.05).Conclusion:When enteral nutrition is givened in patients with severe acute pancreatitis,the effect of low-speed incremental infusion is more effective,which can quickly re

关 键 词：营养状况 重症急性胰腺炎 肠内营养 喂养耐受性 

分 类 号：R576[医药卫生—消化系统]