早期肠内营养联合谷氨酰胺在重症急性胰腺炎中的应用

Application of Early Enteral Nutrition Combined With Glutamine in Patients With Severe Acute Pancreatitis

目的分析早期肠内营养联合复方谷氨酰胺在重症急性胰腺炎临床治疗中的疗效。方法选取2014年1月—2016年6月内蒙古包钢医院接收的符合临床研究的96例SAP患者。采用随机数表法将96例患者分为观察组和对照组,各48例。给予对照组患者早期肠内营养(EN),给予观察组患者早期肠内营养联合复方谷氨酰胺。对比两组治疗后的急性生理与慢性健康状况Ⅱ(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)评分、血清肿瘤坏死因子α(tumor necrosisfactor alpha,TNF-α)、白介素6(interleukin 6,IL-6)、白介素10(interleukin 10,IL-10)、C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)的水平;以及肝、肾功能和血清白蛋白水平。结果治疗后第7 d观察组患者的APACHEⅡ评分、ALT、BUN、TBIL均较对照组患者较低,ALB增高,比较两组间差异具有统计学意义(P<0.05)。观察组患者的血清TNF-α、hs-CRP、IL-6的水平均低于对照组患者,IL-10高于对照组,比较两组间差异具有统计学意义(P<0.05)。结论早期肠内营养联合复方谷氨酰胺能够显著改善SAP患者临床症状,抑制炎症反应发生。

Objective To assess the curative effect of early enteral nutrition combined with glutamine application in patients with severe acute pancreatitis （SAP）. Methods 96 cases of SAP patients who received clinical research in bmer Mongolia Baogang Hospital from January 2014 to June 2016 were chosen. Randomly 96 patients were divided into observation group and control group, 48 cases in each. The early enteral nutrition （EN） was given to the control group, and the observation group was given early enteral nutrition combined with compound glutamine. Curative effects, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score, liver and kidney function, setum albumin, serum tumor, necrosis factor alpha （TNF-c0, high-sensitivity C-reactive protein （hs-CRP）, interleukin 6 （IL-6） and IL-10 were compared for the two groups. Results On the seventh day after treatment, APACHE II score, ALT, TBIL, BUN were significantly lower in the observation group compared with the control group （P 〈 0.05）, ALB were significantly higher in the observation group compared with the control group （P 〈 0.05）. Serum levels of TNF-α, hs-CRP, and IL-6 were lower and IL-10 was higher in the observation group than in the control group （P 〈 0.05）. Conclusion Early enteml nutrition combined with glutamine is able to significantly improve Clinical symptoms and inhibiting inflammatory response in patients with SAP.