肠内营养对中重度溃疡性结肠炎患者疗效及营养状况改善的价值  

Value of enteral nutrition in improving the efficacy and nutritional status of patients with moderate to severe ulcerative colitis

作　　者：陈喆 申琳 王粉[1] Chen Zhe;Shen Lin;Wang Fen(Department of Gastroenterology,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院消化内科,西安710068

出　　处：《中华保健医学杂志》2024年第6期732-734,共3页Chinese Journal of Health Care and Medicine

基　　金：陕西省自然科学基础研究计划(2024JC-YBQN-0918)。

摘　　要：目的观察全肠内营养对中重度活动期溃疡性结肠炎患者临床结局和营养状况改善情况的影响。方法前瞻性选取2022年6月~2023年12月陕西省人民医院收治的溃疡性结肠炎患者116例,采用分层化随机数表法分为对照组和肠内营养组,各58例。两组患者均给予美沙拉嗪,根据病变累及部位联合灌肠,重度患者给予足量糖皮质激素。对照组给予常规少渣普食,肠内营养组采用全肠内营养,持续6周后采用改良Mayo评分进行疗效评估,比较治疗前后患者体质量指数(BMI)、肱三头肌皮皱厚度(TSF)、血清白蛋白(ALB)、前清蛋白(PAB)、血红蛋白(Hb)。记录患者不良反应。结果肠内营养组治疗后Mayo评分低于对照组[(3.13±2.28)分vs.(4.82±2.93)分],有效率高于对照组(87.93%vs.65.51%),差异有统计学意义(t=3.466、χ^(2)=8.158,P<0.05)。治疗后,肠内营养组BMI、TSF虽高于对照组,但组间差异无统计学意义(P>0.05);而ALB、PAB、Hb均高于对照组,差异有统计学意义(t=4.047、7.062、3.832,P<0.05)。结论中重度活动期溃疡性结肠炎患者配合全肠内营养可改善患者营养状况,提高疗效。Objective To observe the effect of total enteral nutrition on the clinical outcomes and improvement of nutritional status in patients with moderate to severe active ulcerative colitis.Methods A total of 116 patients with ulcerative colitis treated from June 2022 to December 2023 were included in the study.They were randomly divided into two groups using stratified randomization,with 58 patients in the control group and 58 patients in the enteral nutrition group.Both groups were given mesalazine combined with enema according to the affected area of the lesion,and severe patients were given sufficient corticosteroids.The control group received routine low residue general diet,while the enteral nutrition group received full enteral nutrition.After 6 weeks,the modified Mayo score was used to evaluate the efficacy.The body mass index(BMI),triceps skinfold thickness(TSF),serum albumin(ALB),prealbumin(PAB),and hemoglobin(Hb)of patients before and after treatment were compared.Record adverse reactions of patients.Results The Mayo score of the enteral nutrition group was(3.13±2.28),which was lower than the control group's(4.82±2.93),and the effective rate was 87.93%,which was higher than the control group's 65.51%(t=3.466,χ^(2)=8.158,P<0.05).After treatment,although the BMI and TSF of the enteral nutrition group were higher than those of the control group,there was no statistically significant difference between the groups.After treatment,the ALB,PAB,and Hb of the enteral nutrition group were higher than those of the control group(t=4.047,7.062,3.832,P<0.05).Conclusion Combining total enteral nutrition with moderate to severe active ulcerative colitis patients can improve their nutritional status and enhance treatment efficacy.

关 键 词：溃疡性结肠炎 中重度 肠内营养 营养状况 

分 类 号：R574.62[医药卫生—消化系统]