急性感染性坏死性胰腺炎微生态免疫制剂肠内营养支持治疗的应用效果  

Effect of enteral nutrition support therapy with microecological immune preparations on treatment of patients with acute infectious pancreatic necrosis

作　　者：和青森 钱国武[2] 张雪丹 史娟[3] 闪海霞[4] 孙晓林[5] HE Qing-sen;QIAN Guo-wu;ZHANG Xue-dan;SHI Juan;SHAN Hai-xia;SUN Xiao-lin(Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院神经重症一病区,河南南阳473000 [2]南阳市中心医院普通外科胃肠二病区,河南南阳473000 [3]南阳市中心医院脾脏外科,河南南阳473000 [4]南阳市中心医院感染性疾病一病区,河南南阳473000 [5]南阳市中心医院护理部,河南南阳473000

出　　处：《中华医院感染学杂志》2024年第22期3402-3407,共6页Chinese Journal of Nosocomiology

基　　金：河南省科技发展计划基金资助项目(182102311210)。

摘　　要：目的探究急性感染性坏死性胰腺炎(IPN)微生态免疫制剂肠内营养(EN)支持治疗的应用效果。方法选取2020年12月-2023年10月南阳市中心医院收治的急性IPN患者97例为研究对象,按不同EN治疗方式分为研究组52例(给予常规EN干预及微生态免疫制剂治疗)和常规组45例(给予常规EN干预)。对比两组患者干预前后的实验室指标、肠道菌群;比较随访28 d内患者并发症发生率及预后情况。结果两组患者干预后血清免疫球蛋白(Ig)A、IgM、IgG、血钙水平及厚壁菌门、放线菌门相对丰度均高于干预前(P<0.05),且研究组高于常规组(P<0.05);两组患者干预后血清白细胞介素-6、C-反应蛋白、降钙素原、白细胞计数、淀粉酶、脂肪酶、乳酸脱氢酶水平及变形菌门、拟杆菌门相对丰度均低于干预前(P<0.05),且研究组低于常规组(P<0.05);两组干预后腹内压及Ranson评分均低于干预前(P<0.05),且研究组低于常规组(P<0.05);研究组患者并发症发生率低于常规组(P<0.05);两组28 d内病死率比较,无统计学差异。结论相较于常规EN支持,微生态免疫制剂EN支持可提高急性IPN患者免疫功能,减轻炎症,缓解病情,改善肠道菌群,降低并发症发生风险,改善预后。OBJECTIVE To explore the effect of enteral nutrition(EN)support therapy with microecological immune preparations on treatment of the patients with acute infectious pancreatic necrosis(IPN).METHODS A total of 97 patients with acute IPN who were treated in Nanyang Central Hospital from Dec.2020 to Oct.2023 were recruited as the research subjects and were divided into the study group with 52 cases(conventional EN intervention and microecological immune preparations therapy)and the conventional group with 45 cases(conventional EN intervention)according to the EN treatment methods.The laboratory test indexes and intestinal flora were compared between the two groups before and after the intervention.The incidence rates of complications and treatment outcomes were compared within a 28-day follow-up.RESULTS The levels of serum immunoglobin(Ig)A,IgM,IgG and blood calcium as well as the relative abundance of Firmicutes and Actinobacteria of the two groups of patients were higher after the intervention than before the intervention(P<0.05).The above indexes of the study group were higher than those of the conventional group(P<0.05).The levels of serum interleukin-6,C-reactive protein,procalcitonin,white blood cell,amylase,lipase and lactate dehydrogenase as well as the relative abundance of Proteobacteria and Bacteroidetes of the two groups of patients were lower after the intervention than before the intervention(P<0.05),and the above indexes of the study group were lower than those of the conventional group(P<0.05).The intraabdominal pressure and Ranson score of the two groups were lower after the intervention than before the intervention(P<0.05),and the above indexes of the study group were lower than those of the conventional group(P<0.05).The incidence of complications of the study group was lower than that of the conventional group(P<0.05).There was no significant difference in the 28-day mortality rate between the two groups.CONCLUSION As compared with the conventional EN support therapy,the EN support therapy with mi

关 键 词：微生态免疫制剂 肠内营养 急性感染性坏死性胰腺炎 胃肠功能 免疫球蛋白 

分 类 号：R576[医药卫生—消化系统]