益生元、益生菌联合早期肠内营养对胰腺损伤胃肠功能恢复的影响

Efficacy of prebiotics and probiotics in early enteral nutrition for the recovery of gastrointestinal function of pancreas trauma

目的研究益生元、益生菌联合早期肠内营养对胰腺损伤患者术后胃肠道功能恢复、营养状态改善和预后的影响。方法回顾性分析2012年1月至2017年12月郑州大学第一附属医院收治的胰腺损伤患者的资料，患者分成3组：A组：对照组，给与手术和一般性治疗；B组：在A组治疗基础上给与益生元和益生菌；C组：在B组基础上给与早期肠内营养。比较三组胃肠道恢复情况、血生化指标、病死率、腹痛消失时间、术后总住院时间、住院费用、并发症发生率等的差异。结果C组患者腹痛消失时间、住院时间、住院费用均显著低于其他组（P〈0．05），差异有统计学意义。与A组和B组相比，C组患者术后1周胃肠功能障碍评分显著降低（P〈0．05），差异有统计学意义。C组患者术后1周、2周血清淀粉酶、脂肪酶及CRP水平明显低于其他组（P〈0．05），差异有统计学意义。血浆白蛋白水平明显高于其他组（P〈0．05），差异有统计学意义。结论益生元、益生菌联合早期肠内营养对胰腺损伤肠道功能恢复有一定优势，值得临床推广。

Objective To study the influence of prebiotics and probiotics combined with early enteral nutrition （EN） on the recovery of gastrointestinal function, improvement of nutritional status and prognosis in postoperative patients with pancreatic trauma. Methods A retrospective analysis of the clinical data of pancreatic injury patients admitted to our hospital from January 2012 to December 2017 was carried out, and those patients were divided into 3 groups： group A （control group）, patients treated with operation and routine treatment; group B, patients treated with prebiotics and probioties in addition to surgery and routine treatment; group C, patients treated as group B in addition to early EN. Comparisons of blood biochemical markers, mortality, time required for resolution of abdominal pain, length of hospital stay, hospitalization expenses and complication rate among three groups. Results The time required for resolution of abdominal pain, length of hospital stay, hospital costs in group C were significantly lower than those in other groups （P 〈 0.05）. The score of gastrointestinal dysfunction at one week after surgery in group C was significantly lower than that in group A and group B （P〈0.05）. Serum amylase, lipase and CRP levels were significantly lower in group C than those in other groups （P 〈 0.05）. Plasma albumin level significantly higher in group C than that in other groups （P 〈 0.05）. Conclusion Prebiotics and probiotics combined with early EN treatment have certain advantages in patients with pancreatic injury.