肠内营养不同输注速度对重型急性胰腺炎患者营养状况、胃肠功能恢复效果的影响  

Effects on nutritional status and gastrointestinal function recovery of different infusion rates of enteral nutrition in patients with severe acute pancreatitis

作　　者：闵瑶 李文怡 MIN Yao;LI Wenyi(Department of Hepatobiliary and Pancreatic Surgery,The First People's Hospital of Jiujiang City,Jiujiang City,Jiangxi Province,332000,China,2.Department of Otolaryngology Head and Neck Surgery,The First People's Hospital of Jiujiang City,Jiujiang City,Jiangxi Province,332000,China)

机构地区：[1]江西省九江市第一人民医院肝胆胰外科,江西九江332000 [2]江西省九江市第一人民医院耳鼻喉头颈外科,江西九江332000

出　　处：《蛇志》2023年第3期342-345,共4页Journal of Snake

摘　　要：目的探讨肠内营养不同输注速度在重型急性胰腺炎(SPA)患者中的应用效果。方法回顾性分析2020年3月至2023年3月我院收治的106例重型急性胰腺炎患者的临床资料,均采取肠内营养支持,初始输注速度为30 ml/h,并根据肠内营养不同输注速度分为低速组(10 ml/h速度增加,20 h内增加到80 ml/h)和高速组(20 ml/h速度增加,12 h内增加到80 ml/h),各53例。比较两组患者的腹内压水平、营养状况、炎症水平、胃肠功能及喂养不耐受发生情况。结果营养支持前,两组患者的腹内压水平、营养状况、炎症水平比较,差异均无统计学意义(P>0.05);营养支持12 h时,低速组患者的腹内压水平明显低于高速组,差异均有统计学意义(均P<0.05)。营养支持7 d时,低速组患者的血清白蛋白(ALB)、转铁蛋白(TRF)、前白蛋白(PA)水平均高于高速组,肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、降钙素原(PCT)水平低于高速组,差异均有统计学意义(均P<0.05)。两组患者的排气及排便、肠鸣音、经口进食、腹胀缓解时间比较,低速组均短于高速组,喂养不耐受发生低于高速组,差异均有统计学意义(均P<0.05)。结论低速增加肠内营养输注速度可降低SPA患者腹内压,改善机体营养状况,促进胃肠功能恢复,降低喂养不耐受的发生。Objective To investigate the effect of different infusion rates of enteral nutrition in patients with severe acute pancreatitis(SPA).Methods The clinical data of 106 patients with severe acute pancreatitis admitted to our hospital from March 2020 to March 2023 were retrospectively analyzed.All patients received enteral nutrition support with an initial infusion rate of 30 ml/h,and were divided into low group according to different infusion rates of enteral nutrition(10 ml/h with increased speed,10 ml/h with increased speed).There were 53 cases in each group(increased to 80 ml/h within 20 h)and high speed group(increased to 80 ml/h within 12 h).The levels of internal abdominal pressure,nutritional status,inflammation,gastrointestinal function and feeding intolerance were compared between the two groups.Results Before nutritional support,there was no statistical significance in intra-abdominal pressure,nutritional status and inflammation between 2 groups(P>0.05).After 12 h of nutritional support,the level of internal abdominal pressure in low speed group was significantly lower than that in high speed group,with statistical significance(all P<0.05).After 7 days of nutritional support,serum albumin(ALB),transferrin(TRF)and prealbumin(PA)levels in low-velocity group were higher than those in high-speed group,while tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and procalcitonin(PCT)levels in low-velocity group were lower than those in high-speed group.The differences were statistically significant(all P<0.05).The relief time of exhaust and defecation,bowel sound,oral eating and abdominal distension in low speed group was shorter than that in high speed group,and the occurrence of feeding intolerance was lower than that in high speed group,with statistical significance(all P<0.05).Conclusion Increasing the speed of enteral nutrition infusion at low speed can reduce the internal abdominal pressure in SPA patients,improve the nutritional status of the body,promote the recov

关 键 词：重型急性胰腺炎 肠内营养 不同输注速度 腹内压水平 营养状况 胃肠功能 

分 类 号：R657.5[医药卫生—外科学]