早期肠内生态免疫营养在重症急性胰腺炎治疗中的作用

The early enteral ecoimmunonutrition in severe acute pancreatitis

目的 探讨重症急性胰腺炎（SAP）时早期给予生态免疫肠内营养的可行性、安全性及有效性。方法 2004年10月至2006年10月间25例SAP患者在入院3～5d时放鼻空肠螺旋管．在到达空肠后．进行肠内生态免疫营养支持。观察患者的一般情况、营养状况、免疫功能、TNF-α、IL-10的变化及并发痖的发生率等：结果25例患者均成功置管到达空肠．2例置管第4天时在X线透视辅助下置入空肠，3例在置管第4天时在内镜辅助下进入空肠。所有患者对早期肠内生态免疫营养耐受良好，无胰腺炎复发．而且肠内生态免疫营养开始后1-2周营养状况及免疫功能与营养支持前比较明显好转，TNF-α较肠内营养前显著降低（P〈0．05）．IL-10较前显著升高（P〈0．05）．且无胰腺坏死组织继发感染的发生。结论对SAP早期给予肠内生态免癌营养支持是可行、安全和有效的．能改善SAP患者的营养状况及免疫功能。

Objective To evaluate the feasibility,safety and validity of the early enreral vere acute pancreatitis（SAP）. Methods 25 patients of SAP during October 2004 and October 2006 had received early enteral ecoimmunonutririon through naso-jejunal tube. The nutrition and immune index and the rates of complications were analyzed. Results 2 clays after nutrition tube placed to stomach, the tube heads in 20 cases reached the jejunum automatically, while 2 cases needed the help of X-ray and 3 cases needed the help of gastroscopy. All of 25 cases could well role, rate the enteral ecoimmunonutrition,and there was no relapse of SAP. TNF-α was significantly decreased and IL-10 was significantly increased（ P 〈 0.05） ,and the nutrition and immune measurement were improved after 1 - 2 weeks enteral nutrition, without infection of pancreatic necrosis. Conclusion It is safe, efficient and feasible of the early enteral ecoimmunonutririon in severe acute pancreatiris（SAP） through naso-jejunal tube. Early enteral ecoimmtmonutrition can improve the nutrition, immune function and prognosis of patients of SAP.