全胃肠外营养联合谷氨酰胺二肽对重症胰腺炎患者非手术治疗的意义

Significance of Application of Total Parenteral Nutrition Associated with Alanyl-glutamine on Patients with Acute Severe Pancreatitis

目的观察全胃肠外营养联合谷氨酰胺二肽在急性重症胰腺炎非手术治疗中的作用。方法48例急性重症胰腺炎患者随机分为2组。Ⅰ组在传统保守治疗原则基础上实施全胃肠外营养(TPN)治疗,Ⅱ组在Ⅰ组方案基础上给予谷氨酰胺二肽治疗,测定血清白蛋白水平、血浆谷氨酰胺浓度、氮平衡、T淋巴细胞转化率等指标。结果治疗2周后Ⅱ组患者的血清白蛋白、血浆谷氨酰胺浓度、氮平衡、T淋巴细胞转化率均高于Ⅰ组(P<0.05)。结论在急性重症胰腺炎传统的非手术治疗方案基础上,给予谷氨酰胺二肽联合TPN治疗,可明显改善患者的营养状态,促进氮平衡的恢复,提高机体免疫力,减少死亡率及并发症的发生率。

Objective To investigate the therapeutic effect of total parenteral nutrition （TPN） associated with alanyl - glutamine on patients with acute severe pancreatitis （SAP）. Methods Forty - eight patients with SAP were randomly divided into two groups according to different therapeutic programs. 2.5 cases in group I were treated by traditional method combined with TPN, 23 cases in group Ⅱ were treated by TPN and glutamine- supplemented TPN. The concentration of se- rum albumin and plasmal glutamine, nitrogen balance, the transforming rate of T lymphocyte in each group were observed respectively. Results After 2 weeks of treatment, the concentration of serum albumin and plasmal glutamine, nitrogen bal- ance, the transforming rate of T lymphocyte in group Ⅱ were higher than those of group I . Conclusions Combined with conventional therapy, TPN and glutamine- supplemented TPN therapy can improve the nutrition and immunity state of patients and accelerate the recovery of nitrogen balance, so reduce the mortality and morbidity of complications.