不同营养支持途径对ICU急性出血性胰腺炎患者营养状况及免疫功能的影响

Study on the influence of different nutrition support ways on nutritional status and immune function of patients with acute hemorrhagic pancreatitis in ICU

目的探讨早期肠内营养与全胃肠外营养对ICU急性出血性胰腺炎患者营养状况及免疫功能的影响。方法选取86例在入住消化科及ICU室的急性出血性胰腺炎患者为研究对象,按营养支持途径不同分为早期肠内营养组(EEN组)与全胃肠外营养组(TPN组),各43例,比较两组患者营养支持前后营养状况及免疫功能变化。结果营养支持后7 d,两组营养状况及免疫力功能指标均有所改善;EEN组患者白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TF)水平均显著高于TPN组,Ig A、Ig G、Ig M水平也显著高于TPN组,CD3、CD4、CD4/CD8、NK细胞及B淋巴细胞水平也显著高于TPN组,差异均有统计学意义(P<0.05)。结论 EEN和TPN均能有效改善急性出血性胰腺炎患者的营养状况及免疫功能,但EEN优于TPN,建议临床上采用EEN进行营养支持。

Objective To explore the influence of different nutrition support ways on nutritional status and immune function of patients with acute hemorrhagic pancreatitis in ICU. Methods A total of 86 patients with acute hemorrhagic pancreatitis in ICU and department of gastroenterology in this hospital were selected for this study. They were assigned to early enterogastric nutritional support（ EEN） group and. total parenteral nutrition support（ TPN） group according to different nutrition support ways,with 43 patients in each group. Changes in nutritional status and immune function before and after nutritional support of these 2 groups had been studied and compared. Results After the nutritional support for7 d,the blood levels of ALB,PA and TF in patients of EEN group were higher than those of patients in TPN group,the blood levels of Ig A,Ig G and Ig M were also significantly higher than those of patients in TPN group,the levels of CD3,CD4,CD4 / CD8,NK cells and B lymphocytes were significantly higher than those of patients in TPN group,and the difference was statistically significant（ P〈0. 05）. Conclusion EEN and TPN can effectively improve the nutritional status and immune function of patients with acute hemorrhagic pancreatitis,but EEN is better than that of TPN,hence EEN is recommended for nutritional support in clinical practice.