早期营养支持对急性重症胰腺炎病人机体组成的影响

The effect of early enternal nutrition combined with parenteral nutrition on the body composition of ASP patients

目的:探讨早期肠内营养(EN)联合肠外营养(PN)对急性重症胰腺炎(ASP)病人机体组成的影响。方法:将30例病人随机分成治疗组和对照组。治疗组病人采取早期EN加PN,并逐渐减少PN的用量,直至停止PN。对照组病人采取完全胃肠外营养(TPN)。两组病人平均治疗15d。用皮皱测量法测定两组病人机体密度,用MRI方法测量全身各部位脂肪变化情况,核素稀释法测定全身水量(TBW)、总脂肪量(TBF)、无脂肪体重(LBM)、细胞内液(ICM)、细胞外液(ECM)的变化。同时常规测定血清清蛋白、血红蛋白、转铁蛋白和淋巴细胞数量等。结果:治疗组在TBW、TBF、LBM、ICM、ECM、血清清蛋白、血红蛋白、转铁蛋白与对照组差异无显著性意义(P>0.05),治疗组的淋巴细胞数高于对照组(P<0.05)。结论:早期EN联合PN可以改善ASP病人的机体免疫功能,对机体组成的影响,与TPN无差异。

objective：To investigate the effect of early enternal nutrition combined with parenteral nutrition on the body composition of SAP patients. Methods：30 ASP patients were divided into two groups randomly ,treatment group and control group. The patients in treatment group were supported with early EN combined with PN. The patients in control group were supported with TPN. The skin-fold and the change of fat were measured. Isotope dilution technique was used to measure TBW, TBF, LBM, ICM, ECM. Results：The TBW,TBF,LBM,ICM,ECM,albumin,Hb,transferrin in treatment group showed no statistical difference from control group（P 〉0.05）. But, the count of lymphocyte in treatment group was higher than that in control group （ P 〈 0.05 ）. Conclusion ： Early EN combined with PN has no significantly different effect on the body composition from TPN, but it can improve the immune state of ASP patients.