肠内肠外营养对急性重症胰腺炎患者术后的影响

Influence of enteral nutrition or parenteral nutrition in patients with severe acute pancreatitis postoperation

目的探讨肠内营养与肠外营养对急性重症胰腺炎患者术后的影响。方法对ICU收治的52例急性重症胰腺炎术后患者,根据治疗方法分为肠内营养组+肠外营养组(EN+PN组,n=26)与全肠外营养组(TPN组,n=26)。观察两组患者治疗前后、营养代谢指标(前白蛋白、转铁蛋白)及免疫功能(IgA、IgG、IgM水平;CD4+、CD8+、T细胞比值)的变化情况。结果与TPN组比较,EN+PN组治疗营养代谢指标前白蛋白下降,差异有统计学意义(t=8.26,P<0.05);而免疫功能IgA、IgG、IgM、CD4+、CD8+、CD4+/CD8水平改变差异亦有统计学意义(t分别=9.57、5.30、11.09、3.94、3.61、2.19,P均<0.05)。结论早期肠内营养在促进蛋白质合成代谢、促进免疫功能恢复方面优于肠外营养。

Objective To explore the influence of enteral nutrition or parenteral nutrition in patients with severe acute pancreatitis postoperation.Methods Fifty two cases of severe acute pancreatitis patients under treatment were divided into enteral nutrition group＋ parenteral nutrition（EN＋PN group,n=26） and total parenteral nutrition group（TPN group,n= 26）.Before and after treatment serum indicators of nutritional and metabolic indicators（pre-albumin,transferrin） and immune function（IgA,IgG,IgM levels;CD4＋,CD8＋,T cell ratio） changes were observed.Results Compared with TPN,metabolic markers of nutrition decreased in the EN＋PN group which had statistic difference（t=8.26,P0.05）;and IgA,IgG,IgM,CD4＋,CD8,CD4＋/CD8 levels had changed statistically significant（t=9.57,5.30,11.09,3.94,3.61,2.19,P0.05）.Conclusions Early enteral nutrition has advantages in improving protein synthesis and metabolism in the liver,boosting the immune function recovery compared with parenteral nutrition.