早期鼻空肠营养给予整蛋白制剂与短肽制剂治疗急性重症胰腺炎的对比分析
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摘要
目的:探讨与比较早期鼻空肠营养给予整蛋白制剂与短肽制剂治疗急性重症胰腺炎(SAP)的效果。方法:收集2015年5月至2017年5月入院的80例SAP患者随机分为两组,整蛋白制剂组给予整蛋白制剂营养支持,短肽制剂组患者则采用短肽制剂,比较两组疾病严重程度参数、感染指标、营养指标与并发症。结果:整蛋白制剂组患者营养开启后14d APACHEⅡ评分、SOFE评分、营养风险评分与CTSI评分组间比较均显著性低于短肽制剂组;营养后7d血浆内毒素、血浆DAO与尿液IFABP水平和营养后14d PCT、淀粉酶、血浆内毒素、血浆DAO、尿液IFABP与铁蛋白组间比较均显著性低于短肽制剂组;前白蛋白与白蛋白水平组间比较均显著性高于短肽制剂组,存在显著性差异(P<0.01);总体并发症发生率明显低于短肽制剂组,存在明显差异(P<0.05)。结论:早期鼻空肠给予整蛋白制剂治疗SAP的效果疗效显著,具有借鉴意义。
Objective: To investigate the effects of early nasal jejunal nutrition on patients with acute severe pancreatitis(SAP) treated with whole protein preparations and short peptide preparations. Methods:Eighty patients with SAP who were admitted to hospital from May 2015 to May 2017 were randomly divided into two groups. The whole protein preparation group was given nutritional support of whole protein preparation,and the short peptide preparation group was short peptide preparation. The two groups of diseases severity parameter,infection index,nutrition index and complication. Results: The levels of APACHE Ⅱscore,SOFE score,nutrition risk score and CTSI score in the whole protein preparation group were significantly lower than those in the short peptide preparation group at 14 th day after nutrition was turned on. The levels of plasma endotoxin,plasma DAO and urine IFABP The levels of PCT,amylase,plasma endotoxin,plasma DAO,urine IFABP and ferritin were significantly lower than those of the short peptide preparation group on the 14 th day after nutrition. The pre-albumin and albumin levels were significantly higher than those of the short peptide(P<0.01). The overall complication rate was significantly lower than that of the short peptide preparation group(P<0.05). Conclusion: The effect of early nasal jejunal administration of whole protein preparation on SAP is significant and has reference value.
Objective: To investigate the effects of early nasal jejunal nutrition on patients with acute severe pancreatitis(SAP) treated with whole protein preparations and short peptide preparations. Methods:Eighty patients with SAP who were admitted to hospital from May 2015 to May 2017 were randomly divided into two groups. The whole protein preparation group was given nutritional support of whole protein preparation,and the short peptide preparation group was short peptide preparation. The two groups of diseases severity parameter,infection index,nutrition index and complication. Results: The levels of APACHE Ⅱscore,SOFE score,nutrition risk score and CTSI score in the whole protein preparation group were significantly lower than those in the short peptide preparation group at 14 th day after nutrition was turned on. The levels of plasma endotoxin,plasma DAO and urine IFABP The levels of PCT,amylase,plasma endotoxin,plasma DAO,urine IFABP and ferritin were significantly lower than those of the short peptide preparation group on the 14 th day after nutrition. The pre-albumin and albumin levels were significantly higher than those of the short peptide(P<0.01). The overall complication rate was significantly lower than that of the short peptide preparation group(P<0.05). Conclusion: The effect of early nasal jejunal administration of whole protein preparation on SAP is significant and has reference value.
引文
[1]金洲祥,刘海斌,王向昱.早期肠内营养对肥胖急性重症胰腺炎患者预后的影响[J].中国病理生理杂志,2014,30(2):347~350.
[2]Talebi-Bakhshayesh M,Mohammadzadeh A,Zargar A.Timing of cholecystectomy after acute severe pancreatitis in pregnancy[J].Malays Med Sci,2015,22(3):68~70.
[3]陈健,王磊,李炳庆,等.肠内营养支持治疗对急性重症胰腺炎肠黏膜屏障功能及细菌移位的影响[J].中国老年学杂志,2014,(12):3325~3326.
[4]中华医学会消化病学分会胰腺疾病学组,编辑委员会中华胰腺病杂志,编辑委员会中华消化杂志.中国急性胰腺炎诊治指南(2013年,上海)[J].临床肝胆病杂志,2013,29(9):656~660.
[5]黄鹤,田昭涛,李雨.短肽型营养制剂对重症急性胰腺炎患者肠道黏膜屏障功能的影响[J].中国急救医学,2011,31(12):1100~1102.
[6]李进展,张会迎,吴俊伟,等.早期应用肠内营养对急性重症胰腺炎预后的影响[J].广东医学,2012,33(11):1597~1598.
[7]Jiang L,Ding W,Zhang M.The progressive increase of the platelet count in a patient with acute severe pancreatitis[J].Am Emerg Med,2017,35(1):191.
[8]林莹,杨军红,田曦,等.短肽型肠内营养制剂对儿童胰腺炎营养治疗的效果观察[J].肠外与肠内营养,2016,23(1):21~23.
[9]Mishreki A P,Bowles M J.A case of widespread aortic thrombosis secondary to acute severe pancreatitis[J].Ann R Coll Surg Engl,2011,93(4):e17~e18.
[10]刘云峰,高咏梅,高会斌,等.早期经口进食和鼻空肠营养治疗重症急性胰腺炎价值比较[J].河北北方学院学报(自然科学版),2016,32(6):36~37.
[11]孔娟,李鹏.急性重症胰腺炎合并多器官功能损伤55例临床分析[J].江苏医药,2017,43(1):75~76.
[12]Qiao Y Y,Liu X Q,Xu C Q,et al.Interleukin-22 ameliorates acute severe pancreatitis-associated lung injury in mice[J].World Gastroenterol,2016,22(21):5023~5032.
[2]Talebi-Bakhshayesh M,Mohammadzadeh A,Zargar A.Timing of cholecystectomy after acute severe pancreatitis in pregnancy[J].Malays Med Sci,2015,22(3):68~70.
[3]陈健,王磊,李炳庆,等.肠内营养支持治疗对急性重症胰腺炎肠黏膜屏障功能及细菌移位的影响[J].中国老年学杂志,2014,(12):3325~3326.
[4]中华医学会消化病学分会胰腺疾病学组,编辑委员会中华胰腺病杂志,编辑委员会中华消化杂志.中国急性胰腺炎诊治指南(2013年,上海)[J].临床肝胆病杂志,2013,29(9):656~660.
[5]黄鹤,田昭涛,李雨.短肽型营养制剂对重症急性胰腺炎患者肠道黏膜屏障功能的影响[J].中国急救医学,2011,31(12):1100~1102.
[6]李进展,张会迎,吴俊伟,等.早期应用肠内营养对急性重症胰腺炎预后的影响[J].广东医学,2012,33(11):1597~1598.
[7]Jiang L,Ding W,Zhang M.The progressive increase of the platelet count in a patient with acute severe pancreatitis[J].Am Emerg Med,2017,35(1):191.
[8]林莹,杨军红,田曦,等.短肽型肠内营养制剂对儿童胰腺炎营养治疗的效果观察[J].肠外与肠内营养,2016,23(1):21~23.
[9]Mishreki A P,Bowles M J.A case of widespread aortic thrombosis secondary to acute severe pancreatitis[J].Ann R Coll Surg Engl,2011,93(4):e17~e18.
[10]刘云峰,高咏梅,高会斌,等.早期经口进食和鼻空肠营养治疗重症急性胰腺炎价值比较[J].河北北方学院学报(自然科学版),2016,32(6):36~37.
[11]孔娟,李鹏.急性重症胰腺炎合并多器官功能损伤55例临床分析[J].江苏医药,2017,43(1):75~76.
[12]Qiao Y Y,Liu X Q,Xu C Q,et al.Interleukin-22 ameliorates acute severe pancreatitis-associated lung injury in mice[J].World Gastroenterol,2016,22(21):5023~5032.