全肠内营养诱导缓解治疗成人克罗恩病的疗效分析  

Therapeutical factors of exclusive enteral nutrition induced remission in adult patients with Crohn's disease

作　　者：黄龙[1] 郭坤 方健[1] 陶磊 涂建成[1] HUANG Long;GUO Kun;FANG Jian;TAO Lei;TU Jian-cheng(Department of General Surgery,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang 215600,Jiangsu,China;Research Institute of General Surgery.Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210002,Jiangsu,China)

机构地区：[1]苏州大学附属张家港医院普通外科,江苏张家港215600 [2]东部战区总医院/原南京军区南京总医院全军普通外科研究所,南京大学医学院,江苏南京210002

出　　处：《肠外与肠内营养》2023年第3期139-143,共5页Parenteral & Enteral Nutrition

基　　金：张家港市科技支撑计划(社会发展)(ZKS1719)。

摘　　要：目的:探析全肠内营养在活动期克罗恩病(CD)诱导缓解中的作用。方法:筛选2018年1月至2018年12月张家港市多家医院接诊并经临床检查确诊为CD的52例病人作为研究对象,随机分为全肠内营养组与激素组,每组各26例病人。全肠内营养组给予全肠内营养支持治疗,激素组给予氢化可的松治疗,均治疗6周,每7天评估一次。观察比较两组病人治疗后克罗恩病活动指数(CDAI)改善情况以及临床复发指标,分析病人治疗依从性、住院时间、住院费用、治疗后生活质量评分、不良反应及并发症等。结果:全肠内营养组病人治疗4周时、治疗结束后CDAI下降≥70的病人数皆显著多于激素组,两组比较差异均具有显著统计学意义(P<0.05);全肠内营养组病人治疗后CDAI>250、激素加强治疗、其他药物治疗、手术治疗等情况的发生率皆低于激素组,两组病人CDAI>250、激素加强治疗、其他药物治疗发生率比较差异存在统计学意义(P<0.05);次要观察指标方面,全肠内营养组病人生活质量评分、治疗依从性评分均明显高于激素组,全肠内营养组病人住院时间、不良反应及并发症发生率与激素组相比较均较低,两组比较差异均存在统计学意义(P<0.05)。结论:全肠内营养能够诱导活动期CD缓解,降低CDAI评分,提高病人生活质量评分,缩短住院时间,治疗效果安全有效。Objective:To explore the role of exclusive enteral nutrition in inducing remission of CD during the active phase.Methods:A total of 52 patients who were admitted to many hospitals in Zhangjiagang City from January 2018 to December 2018 and were diagnosed with CD through clinical examinations were included.According to the random number method,they were divided into EEN group and glucocorticoid group,with 26 patients in each group.Patients in the EEN group were treated with exclusive enteral nutrition support,and the glucocorticoid group was treated with hydrocortisone.Both were treated for 6 weeks and followed up every 7 days.The improvement of CDAI after treatment and clinical recurrence indicators of patients in the two groups were observed and compared,observe and analyze patients'treatment compliance,hospitalization time,hospitalization costs,and quality of life after treatment Indexes such as scores,adverse reactions and complications.Results:The number of patients in EEN group whose CDAI decreased≥70 after 4 weeks of treatment was significantly higher than that in glucocorticoid group,and the difference between the two groups was statistically significant(P<0.05);the patients in the EEN group had CDAI>250 after treatment,and enhanced glucocorticoid therapy The incidence of other medical treatments and surgical treatments was lower than that of the glucocorticoid group.There was a statistically significant difference in the incidence of CDAI>250,hormone intensive treatment,and other drug treatments between the two groups(P<0.05);the comparison of secondary outcome indexes between the two groups after treatment showed that the scores of quality of life and treatment compliance in EEN group were significantly higher than those in glucocorticoid group,and the length of stay,incidence of adverse reactions and complications in EEN group were lower than those in glucocorticoid group,with statistical significance between the two groups(P<0.05).Conclusion:The exclusive enteral nutrition can significantly improve t

关 键 词：克罗恩病 活动期 全肠内营养 诱导缓解 

分 类 号：R459.3[医药卫生—治疗学] R574[医药卫生—临床医学]