谷氨酰胺联合规范化早期肠内营养治疗对急性重症胰腺炎患者的疗效分析

Effect of Glutamine Combined with Normalized and Early Enteral Nutrition Therapy for Patients with Severe Acute Pancreatitis

目的探讨谷氨酰胺联合规范化早期肠内营养治疗对急性重症胰腺炎(SAP)患者的临床疗效。方法将我院2014年1月至2015年12月收治的96例SAP患者随机分为观察组与对照组,每组各48例。对照组患者采用全肠外营养(TPN)支持治疗,观察组采用谷氨酰胺联合规范化早期肠内营养治疗。分析比较两组的临床疗效。结果治疗第9 d后两组APACHEⅡ评分、TBIL、ALT、AST、BUN、Scr以及Hs-CRP、TNF-α、IL-1β、IL-6、IL-8水平均显著降低,IL-10水平显著升高,且观察组以上指标改善水平显著优于对照组,P<0.001。观察组患者住院时间、死亡率及感染率均显著低于对照组,P<0.05。结论谷氨酰胺联合规范化早期肠内营养治疗有助于改善SAP患者的氨基酸代谢情况,缓解负氮平衡,改善全身炎症状况,缩短住院时间,降低感染率及死亡率。

Objective To explore the clinical efficacy of glutarnine combined with normalized and early enteral nutrition therapy for patients with severe acute pancreatitis （SAP）. Methods From January 2014 to December 2015, 96 SAP patients treated in our hospital were randomly divided into two groups, with 48 cases in each group. The control group received total parenteral nutrition （TPN） support therapy, the observation group received glutamine combined with normalized and early enteral nutrition therapy. The clinical efficacy of two groups was analyzed and compared. Results 9 days after treatment, the score of APACHE II and levels of TBIL, ALT, AST, BUN, Scr, Hs-CRP, TNF-a, IL-1/3, IL-6, IL-8 in two groups decreased significantly, the level of IL-10 increased significantly, and the improvement degree of above indices in observation group was significantly better than that in control group, P 〈0.001. The hospitalization time, mortality and infection rate in observation group were significantly lower than those in control group, P 〈0.05. Conclusions Glutamine combined with normalized and early enteral nutrition therapy for SAP patients helps to improve the amino acid metabolism, relieve the negative nitrogen balance, improve the systemic inflammatory conditions, shorten the hospitalization time and reduce the infection rate and mortality.